| Learning Objective #1: Discuss an interdisciplinary, evidence-based process used to assess and refine a system of care to promote effective and safe responses to episodes of hyperglycemia and hypoglycemia | |||
| Learning Objective #2: Describe the clinical outcomes achieved through improved responses to blood glucose extremes |
Prolonged periods of poor control, increased morbidity, and even death may result from inadequate, poorly timed, or ineffective responses to blood glucose extremes. A review of patient records at a 612-bed hospital revealed patients who experienced wide, rapid, and serious swings in glucose –moving from “panic levels” of hyperglycemia (>400 mg/dl) to hypoglycemia (<60 mg/dl) quickly. The systems and processes of diabetes care were analyzed and literature reviewed to determine best practices related to management of blood glucose extremes.
A project was implemented to improve clinical effectiveness of diabetes management, particularly the effectiveness and safety of responses to glucose extremes. The process included development of new diabetes management protocols, new and supporting documents/forms, and a competency based program for all nursing staff. Staff from nursing, medicine, and other disciplines were engaged in the project design, implementation, and evaluation of effectiveness. Extensive monitoring documented successful compliance with the protocols and identified many positive outcomes associated with the highly successful project, including:
a) Prompt and individualized responses to blood glucose extremes b) Careful monitoring of patient responses c) Dramatic decrease in incidence of “panic values” associated with appropriate response to any abnormal glucose. d) Demonstrated increased staff understanding of diabetes, hyperglycemia, and hypoglycemia and the facility’s related protocols. f) Dramatic decrease (possible elimination) of episodes of dramatic “swings” in blood glucose
The interdisciplinary process used to design the project will be shared, along with description of the competency based learning program, and samples of all documents/monitors. The outcomes, along with many “lessons learned”, will be revealed. The implications for nursing practice and administration are broad, as diabetes is a common disorder and hospitalized patients are at higher than average risk for developing blood glucose extremes. It is essential that nurses be prepared to recognize and respond appropriately to this potentially life-threatening situation.
Back to Initiatives in Adult Patient Education
Back to 37th Biennial Convention - Clinical Sessions
Sigma Theta Tau International