Diabetes is a costly disease that will affect 642 million individuals globally by 2040 (Shrivastav et al, 2018). According to the Centers for Disease Control and Prevention (2017), more than 30.3 million individuals, or 9.4% of the US population, had diabetes in 2015. Its precursor, prediabetes, affects 84.1 million individuals in the United States. Diabetes particularly affects minorities, with type 2 diabetes mellitus being more common in African Americans, Latinos, Native Americans, and Asian American/Pacific Islanders, as well as the aged population (American Diabetes Association, 2018). Diabetes self-care management is vital to good glucose management. Lifestyle modifications, such as maintaining a healthy diet combined with increased levels of daily physical activity, are among the essential strategies recommended. Faith-based settings (churches) play a central role in many communities (Sawani, 2018) and are recognized for their potential capacity to provide health services and interventions to address health disparities in African Americans.

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Objective: The purpose of this study was to measure the level of stress perceived by postoperative coronary artery bypass graft (CABG) patients. Coronary artery bypass graft is the most used surgical intervention to treat patients with coronary artery disease (CAD). Many patients consider CABG surgery as life threatening and stressful. There is a need for nurses to be aware of the patient’s perception of stress to create a more therapeutic environment within the intensive care unit (ICU).Methods: The research method was a quantitative descriptive survey design and descriptive statistics were used for data analysis. A convenience sampling method was used resulting in a sample size of 60 participants who had recently undergone a CABG surgical procedure. The participants completed the Intensive Care Unit Environmental Stressor Scale (ICUESS) survey.Results: The results of the ICUESS survey were analyzed according to rank order and mean with standard deviation scores for each of the 40 items. Findings showed the following stressors were ranked as the highest level of stress: “Being in pain”, “missing your husband or wife”, “having tubes in your nose or mouth”, and “only seeing family and friends for a few minutes each day”.Conclusions: The participants in this study were not highly stressed. Pain was the highest ranked stressor. Nurses need to be aware of the perceived level of stress by the postoperative CABG patients to reduce stressors and enhance recovery. The Neuman Systems Model was appropriate for this study.

Objective: Type 2 Diabetes affects approximately 10% of the population in the United States. Diabetes is associated with acute and long-term complications are more severe. Studies are providing a correlation between better self-care actions and a reduction of undesired diabetes outcomes. The purpose of this study was to evaluate the implementation of a diabetes self-management education (DSME) program on glycemic control that was expected to improve staff knowledge and diabetes outcomes.Methods: This study conducted a quality improvement design. Providers and nursing staff in three primary care clinics were recruited. Diabetes Knowledge Test (DKT) and HbA1c were measured pre and post intervention.Results: Data from 15 staff participants were analyzed. The mean score for the pre-test was 81% while the mean score for the post-test was 87%. A paired t-test revealed t = 1.533, df = 3.998 and p = .160. The HbA1c percentage mean over 6 months decreased by 0.02% and subsequently in 3 months by 0.17%. The Friedman rank sum test was used to compare the differences, χ2(2) = 14.79, p < .001. Post-hoc analysis identified a statistical significance in the HbA1c from implementation to post implementation.Conclusions: There was an increase in the percent score in the provider and nursing staff knowledge after implementation of the DSME program. A decrease in percent change of the HbA1c was identified over the three- month implementation period. This study demonstrated that the implementation of a DSME program may contribute to improved glycemic control.