The Effectiveness of Nurse Coaching in Enhancing Lifestyle Modifications in Type 2 Diabetics for Improved Outcomes

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Introduction: Diabetes mellitus is a worldwide epidemic, with type 2 diabetes (T2D) being the most prevalent type. Diabetes education and self-management contribute to improved outcomes and reduced healthcare costs. Considering the significant burden and adverse outcomes when T2D is uncontrolled or poorly managed, providers must find avenues to motivate patients to actively participate in their care for improved health and well-being. Purpose: The purpose of this quality improvement project was to increase knowledge and improve patients’ self-management of T2D with the implementation of nurse coaching. In addition, this study systematically evaluated the effectiveness of nurse coaching on the modifiable risk factors hemoglobin A1c (HbA1c), blood pressure (BP), high-density lipoprotein(HDL), and body mass index (BMI) among individuals with T2D. Another goal of this project was to assist the clinic to incorporate nurse coaching policies and best practices for uniformity and efficacy. The increased T2D education and resources provided to the patient, while utilizing a patient-centered plan to set and obtain goals, will increase sustainability for a healthier lifestyle. Methods: The nurse coach developed a partnership with participants, delivered diabetes education, and utilized the patient’s strengths and resources to set goals. Adult volunteers (N =18) from a primary care clinic who met the inclusion criteria were enrolled in the study. Participants received routine diabetic care and nurse coaching monthly. Biometrics including HbA1c, BP, HDL, BMI, and wellness outcomes via the ICAN discussion aid were measured at baseline and eight weeks following coaching. Outcome measures were assessed using the Wilcoxon signed-rank test.Results: The outcomes of nurse coaching for T2D are enhanced patient lifestyle modifications as evidenced by improved biometrics. Nurse coaching was associated with a statistically significant improvement in HbA1c, with post-coaching scores (Median = 7.4) being 0.8% lower than pre-coaching scores (Median = 8.2), p = .0011. Blood pressure, HDL, and BMI, though not statistically significant (p>0.05), were lower post-coaching. The ICAN survey responses did not differ for post-coaching (p > 0.05). This project enhanced the understanding of nurse coaching and T2D management for improved biometrics. Discussion: Nurse coaching for T2D enhanced patient awareness of lifestyle modifications as evidenced by improved biometrics. Nurse coaching has the potential to reduce risks,complications, and costs to the healthcare system. Research on clinical effectiveness is essential to support future reimbursement and increase the implementation of nurse coaching across healthcare. Conclusion: Incorporating wellness into everyday life can help combat chronic disease and improve self-management of T2D. The coach’s role is to empower patients to decide what they want to change and how to make healthy modifications. The nurse coach provides patient guidance and education to focus on health promotion and sustainment, which will reduce costs to the patient and healthcare system.

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DNP Project
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Diabetes Mellitus, Type 2, Body mass index, Glycated Hemoglobin, Nurse coach
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