Improving the Clinical Effectiveness of Diabetes Care: Responding to Hyperglycemia and Hypoglycemia

2.50
Hdl Handle:
http://hdl.handle.net/10755/148097
Type:
Presentation
Title:
Improving the Clinical Effectiveness of Diabetes Care: Responding to Hyperglycemia and Hypoglycemia
Abstract:
Improving the Clinical Effectiveness of Diabetes Care: Responding to Hyperglycemia and Hypoglycemia
Conference Sponsor:Sigma Theta Tau International
Conference Year:2003
Author:Wall, Jane, MSN, RN, CNA
P.I. Institution Name:University Hospital
Title:Director of Resource Management
Co-Authors:Mary Jo Goolsby, EdD, MSN, APRN-C, FAANP
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.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleImproving the Clinical Effectiveness of Diabetes Care: Responding to Hyperglycemia and Hypoglycemiaen_GB
dc.identifier.urihttp://hdl.handle.net/10755/148097-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Improving the Clinical Effectiveness of Diabetes Care: Responding to Hyperglycemia and Hypoglycemia</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2003</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Wall, Jane, MSN, RN, CNA</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University Hospital</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Director of Resource Management</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">jwall@uh.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Mary Jo Goolsby, EdD, MSN, APRN-C, FAANP</td></tr><tr><td colspan="2" class="item-abstract">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 &ndash;moving from &ldquo;panic levels&rdquo; of hyperglycemia (&gt;400 mg/dl) to hypoglycemia (&lt;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 &ldquo;panic values&rdquo; associated with appropriate response to any abnormal glucose. d) Demonstrated increased staff understanding of diabetes, hyperglycemia, and hypoglycemia and the facility&rsquo;s related protocols. f) Dramatic decrease (possible elimination) of episodes of dramatic &ldquo;swings&rdquo; 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 &ldquo;lessons learned&rdquo;, 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.</td></tr></table>en_GB
dc.date.available2011-10-26T09:40:21Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T09:40:21Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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