Date of Award


Degree Name

Nursing (M.S.N.)


College of Nursing


The purpose of this paper is to describe a quality improvement project aimed to improve the documentation of hemoglobin A1c in the discharge instructions for patients with a diagnosis of diabetes prior to a transition from the acute care setting. Clinical practice guidelines from the American Diabetes Association and patient education recommendations from The Joint Commission are the impetus for this process improvement. The Plan-Do-Study-Act (PDSA) model was utilized to identify, design, and implement the process change in collaboration with an interprofessional team. The documentation rate of hemoglobin A1c was measured on two medical-surgical inpatient hospital units both pre- and post-intervention implementation. Results of the PDSA cycle improved the documentation rate of A1c in the discharge instructions from 10% at baseline to 40% post-implementation of the process change for a comparative three-month timeframe. Future PDSA cycles warrant the examination of outcome indicators such as readmission rates, cost of care, and improved glycemic control in response to improving a patient’s knowledge of hemoglobin A1c prior to hospital discharge in support of the organization’s population health strategic initiatives.