The implementation of standardized nursing care plans (SNCP), utilizing a common language, aims to streamline nursing data management. However, the impact of SNCP on patient health outcomes, particularly in chronic conditions like Type 2 Diabetes Mellitus (T2DM), has remained an area of investigation. This study delves into evaluating the effectiveness of SNCP, grounded in the North American Nursing Diagnosis Association (NANDA) and Nursing Interventions Classification (NIC) frameworks, in improving key health indicators for individuals with T2DM. These indicators include metabolic control, weight management, and blood pressure regulation.
Conducted as a two-year prospective follow-up study within routine clinical practice in Spain, the research encompassed 31 primary health care centers and a substantial cohort of 24,124 T2DM outpatients. Data was meticulously gathered from Computerized Clinical Records, with SNCP identified through the application of NANDA and NIC taxonomies. Statistical analyses, including descriptive and ANCOVA methods, were employed to assess the outcomes.
The study population was categorized into two groups: a Usual Nursing Care (UNC) group (18,320 patients) and an SNCP group (5,168 patients). After two years, the SNCP group demonstrated improvements across most measured parameters, with the exceptions of LDL cholesterol and diastolic blood pressure. Further analysis, adjusting for baseline values and pre-existing group differences, revealed a broad lowering trend across parameters, although statistically significant reduction was specifically noted in diastolic blood pressure. However, the clinical significance of this diastolic blood pressure reduction was deemed minimal. Interestingly, while the SNCP group showed greater improvements in control values for diastolic blood pressure, HbA1c, LDL-cholesterol, and Body Mass Index, statistical significance was only reached for HbA1c levels. A notable finding was the higher proportion of patients with elevated baseline HbA1c (≥7%) achieving a reduction to below this threshold within the SNCP group.
In conclusion, the adoption of SNCP proved beneficial in achieving glycemic control targets, particularly for T2DM patients who presented with poorly controlled blood sugar levels (HbA1c ≥7%). Furthermore, a slight improvement in diastolic blood pressure was observed in the SNCP group when compared to the UNC group, suggesting a positive, albeit modest, impact on blood pressure management. This research underscores the potential of standardized nursing care diagnosis and plans in enhancing specific aspects of diabetes management, especially in improving glycemic control for those most in need.
Trial registration: ClinicalTrials.gov NCT01482481.
