Improving the Timing of Acute Care Insulin Delivery.
Local problem: Variations in nursing practice were observed across our hospital, a 520-bed acute care teaching facility in the northeast United States, regarding the timing and frequency of insulin administration in adult patients with diabetes. Chart audits noted that RNs administered insulin more...
| Publicado en: | AJN American Journal of Nursing Vol. 124; no. 2; pp. 48 - 55 |
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| Autores principales: | , |
| Formato: | statistics Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
Feb2024
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=176076780&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 176076780 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0002936X AJN jtl: AJN American Journal of Nursing issn: 0002936X maglogo: N pubinfo: dt: Feb2024 vid: 124 iid: 2 pid: 433 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 176076780 176076780 176076780 10.1097/01.naj.0001006704.88157.20 176076780 ppf: 48 ppct: 7 formats: tig: atl: Improving the Timing of Acute Care Insulin Delivery. aug: au: Cohen, Sara Clark, Rebecca R. S. affil: Nurse manager at Pennsylvania Hospital in Philadelphia sug: subj: Acute Care Statistics and Numerical Data Insulin Administration and Dosage Diabetes Mellitus Drug Therapy Time Factors Quality Improvement Quality of Health Care Nursing Practice Academic Medical Centers United States Aged Inpatients Practice Guidelines Nursing Knowledge Professional Compliance Nursing Leaders Nurse Educators Nursing Practice, Evidence-Based Patient Safety Aged: 65+ years ab: Local problem: Variations in nursing practice were observed across our hospital, a 520-bed acute care teaching facility in the northeast United States, regarding the timing and frequency of insulin administration in adult patients with diabetes. Chart audits noted that RNs administered insulin more than one hour after blood glucose results were obtained 97% of the time. In addition, insulin was given at bedtime only 37% of the time. Purpose: The purpose of this quality improvement (QI) project was to improve the care of inpatients requiring insulin by implementing protocols and adjusting practice to align with best practice recommendations. Methods: The clinical nurse education specialist met with a team of staff nurses, providers, nurse leaders, and patient care technicians (PCTs) to formulate protocols and design interventions to ensure improvements in the quality of care for inpatients with diabetes. A sequence of education sessions and an online learning module were developed and assigned to nurses and PCTs to address knowledge gaps, specifically in the pharmacodynamics and safe administration of insulin, as well as how best to provide care to patients with diabetes. Monthly adherence data were disseminated to nurse leaders and educators and reviewed with clinical staff at daily safety huddles and staff meetings. Additional interventions to enhance nursing practice in caring for patients with diabetes included ensuring both bedtime insulin administration and timely insulin delivery. This project began in May 2017 and ended five years later. Results: Two weeks after initial education sessions began in May and June 2017, the frequency of giving bedtime insulin based on the order set and according to the patient's blood glucose levels rose from 37% to 82%, and adherence to best practice protocols continued until final chart audits were performed in May 2022. The frequency of giving insulin less than one hour after obtaining blood glucose results improved from 3% to 64% between October and December 2019, and increased to a sustained level above the project's 92% goal two years later. Conclusion: Protocol development, targeted education, and audits with feedback led to improved care delivery for patients requiring insulin and increased nursing confidence. pubtype: Academic Journal doctype: statistics Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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