2.50
Hdl Handle:
http://hdl.handle.net/10755/182282
Category:
Abstract
Type:
Presentation
Title:
Sliding Scale No More - Implementing a Hospital Wide Basal Prandial Insulin Protocol
Author(s):
McElroy, Jana
Author Details:
Jana McElroy, RN, BSN, CDE, St. Elizabeth Medical Center, Edgewood, Kentucky, USA, email: jmcelroy@stelizabeth.com
Abstract:
Recommended guidelines by the American Diabetes Association and the American College of Endocrinology call for tighter blood glucose control in both critically and non-critically ill patients. Based on these recommendations, a large Midwestern hospital set out to discontinue the use of sliding scale insulin and implement an evidenced based practice change to a house-wide basal prandial insulin protocol. A steering team was formed. Chaired by a nurse, the membership included: an endocrinologist, family practice physicians, hospitalists, a registered dietician, pharmacists, certified diabetes educators and staff nurses from various nursing units. The steering team reviewed literature and existing protocols from other institutions. This formed the guide for creating a basal prandial insulin protocol. The steering team identified strategies to facilitate adoption of the protocol. These strategies included: identifying and addressing physician's concerns, physician education, developing physician champions, educating pharmacists and nutritionists, educating nurses, and developing nurse champions. Concerns specific to nursing included: having enough blood glucose meters, additional time needed to take care of patients, and nurses not being knowledgeable and confident in the implementation of the protocol. Strategies to address these nursing concerns include: intensive education at the hospital targeted to the various professions, education of all new hires, annual education at skills day, and research to determine whether hypoglycemic events are related to the protocol. The adoption of this protocol is continuously progressing. The steering team continues its work of facilitating protocol adoption through ongoing identification of barriers and developing strategies to overcome them. References: Clement Stephen.Better glycemic control in the hospital:Beneficial and feasible. Cleveland Clinic Journal of Medicine 2007; 74,2:111-120.; Hirsch Irl B, Braithwaite Susan. Sliding-Scale Insulin Therapy: An Ineffective Option For Inpatient Glycemic Control. Resident & Staff Physician. 2007; 2:1-10.; Newton Christopher A, Umpierrez Guillermo E. Obtaining Positive Outcomes with Insulin Therapy in Hospitalized Patients. Insulin. 2007.2 (suppl B): S47-56.
Repository Posting Date:
28-Oct-2011
Date of Publication:
28-Oct-2011
Conference Date:
2009
Conference Name:
ANCC National Magnet Conference
Conference Host:
American Nurses Credentialing Center
Conference Location:
Louisville, Kentucky, USA
Description:
"Magnet: Inspiring Innovation, Achieving Outcomes" was the theme and "Explore the relationship among leadership, innovation, and nursing practice outcomes" was the goal of the 13th American Nurses Credentialing Center (ANCC) National Magnet Conference, held 1-3 October, 2009 in Louisville, Kentucky, USA.
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleSliding Scale No More - Implementing a Hospital Wide Basal Prandial Insulin Protocolen_GB
dc.contributor.authorMcElroy, Janaen_US
dc.author.detailsJana McElroy, RN, BSN, CDE, St. Elizabeth Medical Center, Edgewood, Kentucky, USA, email: jmcelroy@stelizabeth.comen_US
dc.identifier.urihttp://hdl.handle.net/10755/182282-
dc.description.abstractRecommended guidelines by the American Diabetes Association and the American College of Endocrinology call for tighter blood glucose control in both critically and non-critically ill patients. Based on these recommendations, a large Midwestern hospital set out to discontinue the use of sliding scale insulin and implement an evidenced based practice change to a house-wide basal prandial insulin protocol. A steering team was formed. Chaired by a nurse, the membership included: an endocrinologist, family practice physicians, hospitalists, a registered dietician, pharmacists, certified diabetes educators and staff nurses from various nursing units. The steering team reviewed literature and existing protocols from other institutions. This formed the guide for creating a basal prandial insulin protocol. The steering team identified strategies to facilitate adoption of the protocol. These strategies included: identifying and addressing physician's concerns, physician education, developing physician champions, educating pharmacists and nutritionists, educating nurses, and developing nurse champions. Concerns specific to nursing included: having enough blood glucose meters, additional time needed to take care of patients, and nurses not being knowledgeable and confident in the implementation of the protocol. Strategies to address these nursing concerns include: intensive education at the hospital targeted to the various professions, education of all new hires, annual education at skills day, and research to determine whether hypoglycemic events are related to the protocol. The adoption of this protocol is continuously progressing. The steering team continues its work of facilitating protocol adoption through ongoing identification of barriers and developing strategies to overcome them. References: Clement Stephen.Better glycemic control in the hospital:Beneficial and feasible. Cleveland Clinic Journal of Medicine 2007; 74,2:111-120.; Hirsch Irl B, Braithwaite Susan. Sliding-Scale Insulin Therapy: An Ineffective Option For Inpatient Glycemic Control. Resident & Staff Physician. 2007; 2:1-10.; Newton Christopher A, Umpierrez Guillermo E. Obtaining Positive Outcomes with Insulin Therapy in Hospitalized Patients. Insulin. 2007.2 (suppl B): S47-56.en_GB
dc.date.available2011-10-28T15:17:19Z-
dc.date.issued2011-10-28en_GB
dc.date.accessioned2011-10-28T15:17:19Z-
dc.conference.date2009en_US
dc.conference.nameANCC National Magnet Conferenceen_US
dc.conference.hostAmerican Nurses Credentialing Centeren_US
dc.conference.locationLouisville, Kentucky, USAen_US
dc.description"Magnet: Inspiring Innovation, Achieving Outcomes" was the theme and "Explore the relationship among leadership, innovation, and nursing practice outcomes" was the goal of the 13th American Nurses Credentialing Center (ANCC) National Magnet Conference, held 1-3 October, 2009 in Louisville, Kentucky, USA.en_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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