Background:
Although metformin is the preferred initial pharmacological choice in type 2 diabetes, there is evidence that reveals a link between metformin use and vitamin B12 deficiency. The American Diabetes Association (ADA) has recently recommended periodic measurement of B12 levels for all patients on metformin.
Local problem:
Medical record data collected for the preintervention period showed that only 5% (n = 23) of patients diagnosed with diabetes and on metformin had B12 levels checked at an internal medicine primary care practice.
Methods:
This was a quasi-experimental project of preintervention and postintervention design using a checklist containing important measures of diabetes control. The project sample population consisted of data of adults with type 2 diabetes aged 18 years and older who were prescribed metformin in the previous year at the primary care practice.
Interventions:
The intervention focused on revising an existing diabetes measures checklist to include a prompt for an annual measurement of B12 levels.
Results:
There was significant improvement in monitoring vitamin B12 levels and discovery of low vitamin B12 levels. These data show that the number of B12 levels checked increased from 23 during the preintervention to 155 during the intervention (p ≤ 0.0000).
Conclusions:
This project supports a conclusion that including a prompt to check B12 levels to an existing checklist increases B12 monitoring in this patient population. Results may encourage other providers to follow the ADA guidelines for monitoring vitamin B12 levels for patients taking metformin.
Background:
State health rankings, national nursing education reform, and increasing awareness of social injustices propelled a college of nursing to transform its strategic plan, infrastructure, and curriculum. The prevalence of social determinants of health (SDOH) in South Carolina indicates a need for the state's health workforce to understand the impact of SDOH and recognize strategies to address and ameliorate SDOH. With the paradigmatic integration of diversity, equity, and inclusion in nursing education, there is a need for programmatic and curricular integration of SDOH to increase awareness, foster understanding, and transform perspectives among nursing faculty, staff, and students.
Method:
Institutional changes were made to improve inclusive excellence, and the evolutionary process is described.
Results:
SDOH-rich resources and experiential learning have been integrated across a college of nursing.
Conclusion:
This journey is ongoing and essential for preparing nurses to advance patient advocacy, health equity, and social justice for diverse populations.
[
J Nurs Educ
. 2021;60(12):703–706.]
Introduction: Obesity in Mexican American children is reaching epidemic proportions. Improved understanding of children’s healthy eating perceptions in culturally diverse populations is needed. The purpose was to describe the meanings and experiences associated with healthy eating from the perspective of Mexican American children. Methodology: The design was a focused ethnography. Midwestern children, aged 11 to 13 years, were interviewed in home and school settings. Leininger’s four phases of qualitative data analysis was used to analyze data. Parental consent/child assent was obtained. Results: Twenty-one children were interviewed. Two themes emerged: (a) Mexican American children connect healthy eating with familiar foods in the context of their ethnic culture; and (b) foods that provide feelings of happiness and well-being are associated with healthy eating. Discussion: This study provides a clear understanding of the meaning and perceptions of healthy eating from the perspective of Mexican American children and offers data to promote culturally congruent care.
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