Year of Publication
Doctor of Nursing Practice
Dr. Nancy R. Kloha
Dr. Tamara Wellman
Dr. Kathy Wheeler
Purpose: The purpose of this study was to evaluate provider adherence to the ADA’s recommendation for an annual screening urinary albumin excretion level to check for the presence of microalbuminuria. A secondary objective was to assess for adequate treatment (i.e. ACE inhibitor or ARB prescription) in those patients with microalbuminuria present.
Methods: A retrospective chart review was conducted on 60 randomly selected patients seen within a primary care practice in an urban university setting between January 1st, 2014 and December 31st, 2014. Inclusion criteria included age ≥ 18 years and an active diagnosis of type 2 DM as evidenced by ICD codes 250.00-250.93. Data collected included age, gender, ethnicity, marital status, insurance type, BMI, tobacco use status, presence or absence of a urinary albumin excretion level collected within the specified timeframe, and presence or absence of an active ACE inhibitor/ARB prescription. A database of 972 qualifying patients was provided by the university’s Division of Biomedical Informatics and 60 patients were randomly sampled from this database utilizing a random number generator.
Results: The retrospective chart review demonstrated that only 1 out of the 60 charts reviewed had received screening for microalbuminuria within the previous calendar year, as recommended by the national guidelines.
Conclusion: Increasing urinary albumin excretion rate screening is essential in early recognition and management of renal complications in patients with type 2 DM. Current rates in many practice settings appear to be suboptimal and there exists an opportunity for quality improvement and identifying strategies for improving screening rates.
Munroe, Whitney R., "Measuring Providers’ Adherence to the American Diabetes Association Screening Recommendation for Prevention of Diabetic Nephropathy" (2015). DNP Projects. 51.