First Advisor

Cullen, Patricia


Rueckert-Hartman College for Health Professions

Degree Name

Doctor of Nursing Practice


Loretto Heights School of Nursing

Document Type

Thesis - Open Access

Number of Pages

120 pages


To meet the healthcare demands of an aging population one strategy is the use of advanced practice nurses (APN) in primary care (Buerhaus, DesRoches, Dittus, & Donelan, 2015). Diabetes affects 26.9% of people aged 65 and older in the United States. Mild cognitive impairment (MCI) is often unrecognized in this population (Munshi, Hayes, Iwata, Lee &Weinger, 2012). Information on APN knowledge of this comorbidity or practice characteristics regarding cognitive function assessment is limited. This capstone project sought to increase understanding of APN practice and knowledge of MCI, comparing APNs board certified in advanced diabetes management (BC-ADM) to those without certification. An original measurement tool, created with expert consultation (Cronbach’s α =.810), was sent via a secure web-based questionnaire to a convenience sample of 743 APNs in active adult practice, who were members of the American Association of Diabetes Educators. Response rate was 29% (n=216). Measured outcomes included knowledge scores on a five-item test, and reported frequency and outcomes of cognitive function assessment. Statistical significance was demonstrated between groups for cognitive function assessment at times other than Medicare Annual Well Visits (X2 (2, n=181)=11.34, p=.003, CI 95%. More APNs without BC-ADM certification completed cognitive function assessment than APNs with BC-ADM certification. Overall, knowledge level did not differ between APN groups. Correlations were found between how APNs answered questions related to executive function symptoms (t=2.71, p=< .05), situations indicating unrecognized MCI (t= 2.45, p=.016), and awareness of the ADA Clinical Practice Recommendations (t=2.034, p=.044). Further research and resource development is indicated.

Date of Award

Summer 2016

Location (Creation)

Colorado (state); Denver (county); Denver (inhabited place)

Rights Statement

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Included in

Nursing Commons