Abstract:
Introduction/Purpose: The diagnosis of gestational diabetes (GDM) predicts type 2 diabetes
(T2DM) development. The 2-hour glucose tolerance test (GTT) is the recommended test to
screen for T2DM in the postpartum (PP). The purpose of this quality improvement is to
increase the postpartum screening rates for T2DM. Research shows vulnerable populations
are under-studied, guidelines are confusing, barriers create challenges, multi-modal
interventions increase rates, and alternate testing methods needed. Methods: Four
interventions specific to this population were used to improve screening rates: a flyer, a
PowerPoint slide, PP visit scheduled with the 2-hour GTT, SMS appointment and 2-hour
GTT reminder. The Self-Efficacy for Diabetes questionnaire assessed self-efficacy and was
uploaded into the patient portal. Five reports were compiled pre-and post-intervention and
compared: number of women with GDM, number of 2-hour GTT ordered and completed,
insurance type, and due date. Self-Efficacy for Diabetes questionnaire assessed self-efficacy
prior to and after the GDM class. Results: A paired samples t-test determined if self-efficacy
increased after the GDM class and visits. The mean difference was statistically significant
with the p-value < .001. A Pearson Chi-Square test of independence was used to determine if
multi-modal interventions improved the screening. Screening rates significantly increased
from pre-intervention (8.14%) to post-intervention (26.3%) p-value = 0.001. The attrition rate
improved from 92% to 73.6% post-intervention. Discussion: Screening rates improved
significantly for MMC. The Self-Efficacy for Diabetes questionnaire scores indicated the
GDM class significantly improved self-efficacy. However, screening rates remain suboptimal.
