Background: Standardized Nursing Care Plans (SNCP), utilizing languages like North American Nursing Diagnosis Association (NANDA) and Nursing Interventions Classification (NIC), are increasingly used to streamline nursing data management. However, their direct impact on patient health outcomes, particularly in chronic conditions like Type 2 Diabetes Mellitus (T2DM), requires thorough investigation. This study aimed to assess the effectiveness of SNCP implementation, based on NANDA and NIC frameworks, in improving metabolic control, weight management, and blood pressure in patients with T2DM.
Methods: This prospective two-year follow-up study was conducted within routine clinical practice across 31 primary health care centers in Spain. The study population comprised 24,124 outpatients diagnosed with T2DM. Patient data was extracted from Computerized Clinical Records, with SNCP identified through the application of NANDA and NIC taxonomies. Statistical analyses included descriptive methods and ANCOVA to evaluate the impact of SNCP.
Results: The study cohort was divided into two groups: a Usual Nursing Care (UNC) group (n=18,320) and an SNCP group (n=5,168). After two years, the SNCP group demonstrated improvements in most measured parameters, with the exception of LDL cholesterol and diastolic blood pressure. Adjustments for baseline values and variables with significant baseline differences between groups revealed a general lowering trend across parameters, excluding HbA1c. Notably, a statistically significant reduction was observed specifically in diastolic blood pressure. While the adjusted diastolic blood pressure reduction was marginal in clinical terms, the SNCP group exhibited greater differences in control values for diastolic blood pressure, HbA1c, LDL-cholesterol, and Body Mass Index. However, statistical significance was only reached for HbA1c. Crucially, a higher proportion of patients with elevated baseline HbA1c (≥7%) achieved a decrease to target levels in the SNCP group.
Conclusions: The implementation of SNCP proved beneficial in achieving glycemic control targets, especially in T2DM patients with initially poor glycemic control (HbA1c ≥7%). Furthermore, a slight improvement in diastolic blood pressure was observed in the SNCP group compared to the UNC group. These findings suggest that utilizing NANDA nursing diagnosis and care plans can be a valuable tool in enhancing the management of Type 2 Diabetes Mellitus, particularly in improving blood sugar control for those most in need.
Trial registration: ClinicalTrials.gov NCT01482481
