Implementing a Prediabetes Screening and Toolkit in the Emergency Department

Literature shows that prediabetes affects millions of people in the United States. Of these individuals, 8 out of 10 are unaware they are prediabetic. Without early intervention, these individuals are at risk for developing complications from diabetes that can be costly, life- altering, or even fatal. Individuals from lower socioeconomic backgrounds are more likely to develop prediabetes and have inadequate preventative medical care, resulting in seeking care in the Emergency Department (ED). EDs have been identified as a practical setting for screening and educating patients. This DNP project aims to determine if a new prediabetic screening and toolkit will identify more positive than negative screening rates, be feasible to implement, and be acceptable and satisfactory to staff. Local Problem: An opportunity to implement a screening and education program was identified in a local community hospital ED. Methods: This quality improvement project surveyed ED staff members to assess the current workflow in the ED setting for integration of a screening and education program. A screening and brief education toolkit was created for staff and patients. A post-implementation survey evaluated the influence of the toolkit on staff feasibility, acceptability, and satisfaction. The effect of the toolkit on positive screening rates was also assessed in the post-implementation survey. Interventions: A screening process was implemented into the workflow of the ED over a 45-day period. This screening process included the utilization of a toolkit by staff and patients. Results: Before this intervention, the facility did not have a prediabetes screening protocol. Post- intervention surveys showed that 100% (n=5) of staff members were satisfied with the screening process and toolkit. All participants reported that the process was easy to use and incorporate into their workflow. Eighty percent (n=4) of the participants reported that screening for prediabetes is feasible. One hundred percent (n=5) would support implementing this screening protocol at their facility in the future and continue using the screening process and toolkit. Conclusion: A community hospital ED successfully implemented a prediabetes screening and education program utilizing a toolkit developed by this project. Participants of this project responded positively to this intervention. They reported that the process was satisfactory to users, easy to use, and feasible to implement.