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- Title
"An Interprofessional Collaboration to Implement and Evaluate an Adult Diabetes Screening Program in a Dental/Dental Hygiene School Clinic".
- Authors
Hack, Gary; Idzik, Shannon
- Abstract
Purpose: The purpose of this project was to collaborate with the School of Nursing and School of Dentistry to determine the feasibility of screening patients for diabetes/prediabetes during their hygiene appointments at the UM dental school clinic. Significance: Diabetes is an epidemic in the United States and is associated with significant morbidity and mortality. Currently, about 18.8 million Americans have diabetes and of those about one third are undiagnosed. 86 million have prediabetes and 90% are unaware. The U.S. Preventative Task Force recommends screening adults who have risk factors for diabetes. Most adults with periodontal disease have at least one risk factor for diabetes. The literature revealed there is a bidirectional relationship between diabetes and periodontal disease. Of, people who are at risk for diabetes, 50% have seen a dentist in the last year. This makes the dental clinic an ideal site for diabetes screening. Dental visit screening enhances the role dental providers' play in the overall health of their patients. Specifically screening in a dental hygiene clinic and at a dental hygiene appointment appear to be a perfect fit between medicine and dental interventions. Interprofessional collaboration among dental hygiene, dental and nurse practitioner faculty toward integrating diabetes screening procedures during dental hygiene care, will be a seamless routinization toward care. Key features: The University of Maryland IRB determined the project was exempted. The dental hygiene clinic was chosen for the screening program. An orientation session was initially provided to the faculty and students by the Dental School and Nursing School faculty and diabetes risk factors were reviewed. During the clinic session those patients with risk factors were offered screening testing with a glucometer. All patients with risk factors were offered written materials about diabetes prevention and the students provided lifestyle recommendations. From those patients who consented to the screening a fingerstick blood glucose sample was obtained. Patients with a fasting result > 100 mg/ dL or random result > 140 mg/dL were referred to their primary care provider. If the patient did not have a primary care provider the patient was referred to the academic center's outpatient diabetes clinic. Currently in Maryland, dental hygienists are NOT allowed to do this screening, thus a dentist within the Dental School faculty along with a Nurse Practitioner, tested the patients. Evaluation Plan / Results: Descriptive statistics were utilized to evaluate the data. A total of 67 patients were seen, 4 were excluded for age; they were under 19 years old. The remaining 63 patients were screened for diabetes risk factors. They ranged in age from 21 to 89 the mean age was 55. Of these 63 patients, 49 (73.1%) had at least one risk factor for diabetes, and 14 (20.9%) did not have any identifiable risk factors. The remaining 45 people were offered a blood glucose evaluation for diabetes with glucometer. Over 50% of the patients (24/55%) agreed to the glucometer evaluation. Of the patients who were screened, 1 patient had an abnormal screen and was referred to the University outpatient diabetes clinic. The remaining 23 screened within normal limits. Conclusion: The screening process flowed easily as part of the dental appointment as many components were already in place. Medical history review was already part of the existing dental hygiene appointment and the dental hygiene students routinely provide health promotion education, as part of the clinic visit. The diabetes screening was well received by faculty, students, and patients. More than half of the patients who with risk factors agreed to be screened. Of those who declined screening, most reported they had been screened elsewhere. However, the numbers were small, thus the next step is to expand the diabetes screening to all of the dental hygiene clinics, and to have the dental hygiene faculty maintain the glucometers and perform the glucometer reading. Ultimately, diabetes screening should be part of the assessment conducted by dental professionals during the medical history/ dental assessment visit. The study showed that it was innovative, easily implemented and patients were very open to being tested.
- Subjects
DIAGNOSIS of diabetes; DENTAL clinics; DENTAL hygiene; INTERPROFESSIONAL relations; HUMAN services programs
- Publication
Journal of Dental Hygiene, 2017, Vol 91, Issue 2, p76
- ISSN
1043-254X
- Publication type
Article