Related Experiment Video
Updated: Jun 11, 2025
12:08
Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
18.8K
Improving Hypertension and Diabetes Mellitus Control with a Dedicated Patient Navigator
Justin Marsden1, Jingwen Zhang1, Chloe Bays1
1From the Department of Medicine, Medical University of South Carolina, Charleston.
Southern Medical Journal
|October 4, 2024
Summary
A patient navigator in a medical home improved blood pressure and diabetes control. This strategy helped 40% of hypertension and 30% of diabetes episodes achieve target levels within 12 months.
Area of Science:
- Internal Medicine
- Cardiology
- Endocrinology
Background:
- Hypertension and diabetes mellitus (DM) are leading causes of major chronic diseases.
- These conditions affect a significant portion of the US population.
- Effective management strategies are crucial for preventing complications.
Purpose of the Study:
- To assess the impact of a patient navigator on blood pressure and glycemic control.
- To evaluate a structured panel management and outreach strategy within a patient-centered medical home (PCMH).
- To determine effectiveness in primary care patients with uncontrolled hypertension and DM.
Main Methods:
- Prospective study design comparing outcomes before and after navigator implementation.
- Utilized a patient navigator executing a hypertension and DM-focused panel management plan.
- Involved 1958 unique patients within a PCMH from January 2014 to October 2019.
Main Results:
- Significant decrease in uncontrolled systolic blood pressure (SBP) over time.
- Approximately 40% of uncontrolled SBP episodes achieved control within 12 months.
- Significant decrease in uncontrolled hemoglobin A1c (HbA1c) over time (P < 0.0001), with ~30% achieving control.
Conclusions:
- A dedicated patient navigator within a PCMH effectively improves BP and glycemic control.
- Achieved 30% glycemic control (HbA1c <8%) and 40% BP control (SBP <140 mm Hg) at 12 months.
- No observed differences in outcomes based on race or poverty.
Related Concept Videos
01:23Hypertension V: Nursing management
2
The nursing management of hypertension involves accurately assessing symptoms, making a comprehensive nursing diagnosis, collaborating with patients to set goals, and implementing targeted interventions to mitigate the condition's impact and improve patient well-being.Comprehensive AssessmentThe initial step in nursing care for hypertension involves a thorough patient assessment. It includes evaluating symptoms such as headaches, dizziness, blurred vision, and previous hypertension episodes.
2
01:25Errors occurring during blood pressure monitoring
607
Blood pressure monitoring is a crucial clinical procedure in diagnosing and managing various cardiovascular conditions. Despite its significance, the accuracy of blood pressure measurements can be compromised by multiple factors, potentially leading to either falsely high or low readings. These inaccuracies are critical as they can significantly impact patient care. So, it is vital to understand these challenges deeply and adopt strategic approaches to minimize errors.
Several factors...
Several factors...
607
01:20Angina V: Nursing Management
4
Angina, a symptom of myocardial ischemia, requires a structured nursing management approach to ensure effective care and prevent complications like myocardial infarction. Comprehensive nursing care involves assessing, diagnosing, planning, implementing interventions, and evaluating outcomes, all tailored to the individual patient's needs.Patient AssessmentNursing assessment begins with a detailed subjective evaluation of symptoms, which typically include chest pain or pressure radiating to the...
4
01:15Diabetes: Management and Pharmacotherapy
243
The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
243
01:23Atherosclerosis IV: Nursing Management
2
Nursing management for a patient with arteriosclerosis involves a comprehensive approach focusing on lifestyle modification, disease monitoring, education, and symptomatic care. Here is an overview of effective nursing strategies:Assessment and Monitoring: Initial and ongoing assessments are crucial. Nurses must document the patient's medical history, including any hypertension, diabetes, hyperlipidemia, and other cardiovascular diseases. Assessments also cover family history and lifestyle...
2
01:18Chronic Kidney Disease IV: Nursing Management
2
Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of...
2