TY - JOUR TI - DKA protocol in medical ICU DO - https://doi.org/doi:10.7282/t3-1fq9-7j56 PY - 2021 AB - Purpose: Diabetic keto acidosis is one of the major metabolic complications of Diabetes. American Diabetic Association recommends structured order sets to ensure high quality inpatient care for hospitalized diabetic patients. This study was conducted to develop, implement, and evaluate an evidence-based DKA protocol to improve DKA management in the adult medical ICU. Methodology: This quality improvement project used a quasi- experimental design to develop, implement and evaluate an evidence-based DKA protocol. Evidence-based DKA protocol was developed based on American Diabetic Association (ADA) 2009 guidelines. Implementation included the education of end-users and incorporation in to the Electronic Health Record (EHR) system. Evaluation was done using a web-based survey of providers to assess their attitudes with regard to the protocol and different aspects of DKA management. Adherence to the protocol was measured as well by the percentage of the total DKA patients on whom the new order set was initiated during the month of implementation. Results: The new evidence-based DKA protocol was implemented with 67% adherence rate among providers with the initiation of the protocol. Most providers found the new order set to be user-friendly, helping to manage DKA than with the traditional approach of treating DKA in the institution. A total of 23 providers answered the survey out of which 75% found the new order set to be highly or extremely effective in the majority of categories of DKA management surveyed such as initiating insulin drip, correcting electrolytes, switching IV fluids, and titrating insulin drip rate and time to closure the anion gap. Implications for practice: Evidence-based DKA protocol facilitated the effective management of DKA at the project site. DKA management is standardized in the institution, which causes less confusion and help streamline the process. There is less delay in initiating IV fluids, insulin, and electrolyte repletion with the convenience of a standardized order set. The findings of this study can be a basis for future evaluation of outcomes such as Length of stay and Anion Gap closure time. The new DKA protocol has become part of the policy and procedure with the successful implementation of the protocol. KW - DKA protocol KW - DKA KW - DKA management KW - Provider survey KW - Hyperglycemia KW - DKA guidelines KW - Post-Master's DNP Practice LA - English ER -