Publication Date

4-2019

Degree Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Jordan Rose

Second Advisor

John Dunlap

Third Advisor

John Roberts

Keywords

Correctional healthcare, diabetes, chronic care theory, prison, complete care model

Abstract

The Complete Care Model (CCM) is a health care delivery model based on the well-studied and internationally validated chronic care theory. Since the integration of the chronic care theory into California Department of Corrections and Rehabilitation (CDCR) patient care in 2008, steady improvement in health care related mortality has been seen, and there have been no unavoidable health care related deaths in CDCR since 2012 (Gransee, 2018). However glycemic control in CDCR diabetic patients has made no statistically significant change since the implementation of the CCM in 2015 when comparing the two years before and the two years after implementation of the CCM. According to the literature, this suggests that key components of the model have yet to be fully incorporated into the CCM (Stellefson et al., 2013). The CCM has been shown to be effective in bringing about positive change in the CDCR health care delivery, but the theory was not implemented robustly enough to achieve CDCR’s goal of 90% of all their diabetic patients having glycated hemoglobin (HbA1c) levels less than 8%. Further research and development of the CCM is still needed to reach the diabetic patient care goals associated with the full adoption of the chronic care theory.

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