Scarlett Ball

In-Service Education Project

Diet 4470
April 10, 2024

In Service-Education Project: GDM Nutrition Education for Nurses

Program Rationale:
The In-Service education was completed on April 3, 2024, at Baystate Wesson Women’s
Group in Springfield, MA. During the discussion with the registered dietitian, it was noted that
the nurses may want some nutrition education. The nurses had minimal to limited education
prior. We talked to the nurses, and they said they would like nutrition education on gestational
diabetes and what we recommend to the patients.
The ambulatory nurses at the OB/GYN are the ones who educate gestational diabetes on
how to use glucose meters and check their blood sugars. Therefore, it was valuable for them to
gain knowledge/ review on the importance of nutrition and balancing blood sugars.

Goals:
1. Provide a brief yet informative session on Gestational Diabetes.
2. Have nurses recite back to me the optimal breakfast choices.
3. An improvement from the Pre-Post Score (80% or Higher)

Identification of the Audience

The target population of this lesson is ambulatory OB/GYN nurses who are primarily middle-
aged females. The presentation will be given to 5 nurses who are knowledgeable about
gestational diabetes and the importance of balancing blood sugars. This staff has prior training in
gestational diabetes nutrition.

Overview of Content
The content of the lesson will focus on the importance of balancing your plate for healthy blood
sugars, the importance of a bedtime snack, and the optimal breakfast choices for patients with
GDM. Therefore, this lesson will be somewhat of a review while testing their existing
knowledge.

Means of Implementation:
This lesson was conducted at noon and was roughly 15-20 minutes. The lesson had to be quick
since the nurses were on their lunch break. The GDM nutrition lesson was very informal; no
visual aids, such as PowerPoint, were used. I supplied two handouts to each nurse (attached at
the end), which they could follow along with. I made a little outline of what I would discuss with
the nurses.

Learner- Center Objectives:

I had three objectives for the nurses:
1) Understand how GDM patients should balance their plates for healthy blood sugars.
2) Understand which carbohydrates affect blood sugar the most and the importance of
decreasing their portion size.
 3) Understand the importance of a bedtime snack to help control fasting blood sugar the
following day.

Before the lesson, I sent out a Google quiz, which everyone completed a week before. After the
lesson, I sent out the post-quiz to see the improvement in scores from pre- to post. The goal was
to see a 25% increase in scores from the pre- to post and get an 80% or higher on the post-test.

Visual Aids/handouts:
*See attached documents
Both handouts were supplied to nursing staff. Since it was an informal meeting at lunch, no
visual aid, such as a PowerPoint, was used during the lesson. However, some food models were
used.

Cost Analysis:
The cost to complete was almost entirely free. The only cost associated with the in-service was
printing two handouts, which cost a few cents for only five people.

Evaluation Tool for the Learner:

A pre-and post-test was used to evaluate the lesson. Staff members answered three questions, one
of which was true or false, and two of which were checked for all that apply. After the lesson
was completed, the identical post-test was administered. Once everyone completed the Google
quiz, I emailed them the correct answers.

Evaluation of the Program:

1. Learner Evaluation: The nurses were very willing to learn about Gestational Diabetes
Mellitus (GDM) nutrition. Before the lesson, all nurses were aware that consuming a
bedtime snack helps control fasting blood sugar levels in the morning. However, there
was varying knowledge regarding which foods affect blood sugar levels and the optimal
breakfast choices for managing GDM. By the end of the lesson, there was a notable
improvement in all nurses' knowledge levels. Specifically, all nurses improved their
understanding from pre- to post-lesson assessments. The pretest score was, on average,
64%. Overall, the collective knowledge gain from pre- to post-assessment was 16 points,
making the average post-test score 80%.

1. Professional staff evaluation of presenter: Sandra Knoll observed the entire lesson. She
thought it was informative and at a reasonable length. She thought I reiterated the most
critical points; for example, if individuals eat white rice, they should eat a vegetable with
it since vegetables are high in fiber and will digest the white rice more slowly.

2. Self-evaluation: This was a very quick and informative session. If I could do this again, I
would have liked to be able to do a PowerPoint since visuals help individuals absorb
information. Also, I would have instead given them the post-quiz right after the session
since the information would have been fresh on their minds. I would have given them the
 correct answers afterward to see if they had any questions. Overall, though I thought I
spoke clearly and concisely,

Suggested plan based on the overall effectiveness of this program:

As previously discussed, incorporating visual aids like PowerPoint presentations alongside
handouts could enhance the program's effectiveness. However, due to the nurses being at lunch
or occupied with work, finding a suitable room for projecting visuals was not feasible at that
time.

Bibliography:

Dietary Recommendations for Gestational Diabetes.” Ucsfhealth.Org, UCSF Health, 1 Mar.

2024, www.ucsfhealth.org/education/dietary-recommendations-for-gestational-diabetes.

Rasmussen L, Poulsen CW, Kampmann U, Smedegaard SB, Ovesen PG, Fuglsang J. Diet and
Healthy Lifestyle in the Management of Gestational Diabetes Mellitus. Nutrients. 2020 Oct
6;12(10):3050. doi: 10.3390/nu12103050. PMID: 33036170; PMCID: PMC7599681.

Vasile FC, Preda A, Ștefan AG, Vladu MI, Forțofoiu MC, Clenciu D, Gheorghe IO, Forțofoiu
M, Moța M. An Update of Medical Nutrition Therapy in Gestational Diabetes Mellitus. J
Diabetes Res. 2021 Nov 18;2021:5266919. doi: 10.1155/2021/5266919. PMID: 34840988;
PMCID: PMC8616668.
Handouts:
This handout I made during my rotation and fit perfectly for the lesson
 UConn In-Service
Pre-Test for GDM Nutrition

1 Does a bedtime snack help control fasting blood sugar the next morning?
Circle the right answer

a. True
b. False

2. Which of these foods affect your blood sugar?

Put an X next to all the foods that affect your blood sugar.

_____ Milk

_____ White Rice

_____ Broccoli

_____ Ricotta Cheese

_____ Unsweetened Cheerios

_____ Chicken

_____ Corn

3. Which of these would NOT be a good breakfast choice for a woman with GDM?
Put an X next to each you think would NOT be a good breakfast choice

_____ Cheese with crackers

_____ Whole bagel with cream cheese

_____ 2 eggs with 2 pieces of whole wheat bread

_____ Whole grain cereal with milk

_____ Whole grain english muffin with peanut butter

_____ Old Fashioned Oatmeal made with milk

_____Egg and Cheese on an 8-inch quesadilla

 UConn In-Service
Post-Test for GDM Nutrition

1 Does a bedtime snack help control fasting blood sugar the next morning?
Circle the right answer

c. True
d. False

2. Which of these foods affect your blood sugar?

Put an X next to all the foods that affect your blood sugar.

_____ Milk

_____ White Rice

_____ Broccoli

_____ Ricotta Cheese

_____ Unsweetened Cheerios

_____ Chicken

_____ Corn

3. Which of these would NOT be a good breakfast choice for a woman with GDM?
Put an X next to each you think would NOT be a good breakfast choice

_____ Cheese with crackers

_____ Whole bagel with cream cheese

_____ 2 eggs with 2 pieces of whole wheat bread

_____ Whole grain cereal with milk

_____ Whole grain english muffin with peanut butter

_____ Old Fashioned Oatmeal made with milk

_____Egg and Cheese on an 8-inch quesadilla

 Correct Answers for Pre and Post

1 Does a bedtime snack help control fasting blood sugar the next morning?
Circle the right answer

a. True
b. False

2. Which of these foods affect your blood sugar?

Put an X next to all the foods that affect your blood sugar.

__X__ Milk

__X___ White Rice

_____ Broccoli

_____ Ricotta Cheese

_X____ Unsweetened Cheerios

_____ Chicken

__X___ Corn

3. Which of these would NOT be a good breakfast choice for a woman with GDM?
Put an X next to each you think would NOT be a good breakfast choice

_____ Cheese with crackers

__X___ Whole bagel with cream cheese

_____ 2 eggs with 2 pieces of whole wheat bread

__X___ Whole grain cereal with milk

_____ Whole grain english muffin with peanut butter

_____ Old Fashioned Oatmeal made with milk

_____Egg and Cheese on an 8-inch quesadilla