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Implementation of Customized Health Information Technology in Diabetes Self Management Programs

Alexander, Susan DNP, CNS, CRNP, BC-ADM; Frith, Karen H. PhD, RN; O'Keefe, Louise MSN, RN; Hennigan, Michael A. MD, FACE, FAACP

doi: 10.1097/NUR.0b013e31820aefd6
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Purpose: The project was a nurse-led implementation of a software application, designed to combine clinical and demographic records for a diabetes education program, which would result in secure, long-term record storage.

Background/Rationale: Clinical information systems may be prohibitively expensive for small practices and require extensive training for implementation. A review of the literature suggests that the use of simple, practice-based registries offer an economical method of monitoring the outcomes of diabetic patients.

Project Description: The database was designed using a common software application, Microsoft Access. The theory used to guide implementation and staff training was Rogers' Diffusion of Innovations theory (1995).

Outcomes: Outcomes after a 3-month period included incorporation of 100% of new clinical and demographic patient records into the database and positive changes in staff attitudes regarding software applications used in diabetes self-management training. These objectives were met while keeping project costs under budgeted amounts.

Conclusions: As a function of the clinical nurse specialist (CNS) researcher role, there is a need for CNSs to identify innovative and economical methods of data collection. The success of this nurse-led project reinforces suggestions in the literature for less costly methods of data maintenance in small practice settings. Ongoing utilization and enhancement have resulted in the creation of a robust database that could aid in the research of multiple clinical issues.

Implications: Clinical nurse specialists can use existing evidence to guide and improve both their own practice and outcomes for patients and organizations. Further research regarding specific factors that predict efficient transition of informatics applications, how these factors vary according to practice settings, and the role of the CNS in implementation of such applications is needed.

Author Affiliations: College of Nursing, University of Alabama in Huntsville (Drs Alexander and Frith and Ms O'Keefe); Diabetes and Lipid Center, Decatur (Dr Hennigan), Alabama.

No funding from the National Institutes of Health, Wellcome Trust, Howard Hughes Medical Institute, or other sources was received for the design and completion of this project.

Correspondence: Susan Alexander, DNP, CNS, CRNP, BC-ADM, 4421 West Pleasant Acres, Decatur, AL 35603 (

© 2011 Lippincott Williams & Wilkins, Inc.