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DKA protocol in medical ICU
Descriptive
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Title
DKA protocol in medical ICU
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Willphine
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Mini
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Mini Willphine
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author
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Avadhani
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Amita
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Amita Avadhani
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Advisory Committee
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chair
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Rutgers University
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School of Nursing - RBHS
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theses
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ETD doctoral
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2021
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2021-01
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English
Abstract
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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.
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.
Subject
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Topic
DKA protocol
Subject
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Topic
DKA
Subject
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Topic
DKA management
Subject
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Topic
Provider survey
Subject
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Topic
Hyperglycemia
Subject
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Topic
DKA guidelines
Subject
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Topic
Post-Master's DNP Practice
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Rutgers University Electronic Theses and Dissertations
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ETD_11322
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1 online resource (46 pages) : illustrations
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DNP
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Includes bibliographical references
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School of Nursing (RBHS) DNP Projects
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rucore10004500001
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doi:10.7282/t3-1fq9-7j56
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The author owns the copyright to this work.
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Willphine
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Mini
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Permission or license
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2020-12-02 01:54:10
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Mini Willphine
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Rutgers University. School of Nursing - RBHS
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Author Agreement License
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I hereby grant to the Rutgers University Libraries and to my school the non-exclusive right to archive, reproduce and distribute my thesis or dissertation, in whole or in part, and/or my abstract, in whole or in part, in and from an electronic format, subject to the release date subsequently stipulated in this submittal form and approved by my school. I represent and stipulate that the thesis or dissertation and its abstract are my original work, that they do not infringe or violate any rights of others, and that I make these grants as the sole owner of the rights to my thesis or dissertation and its abstract. I represent that I have obtained written permissions, when necessary, from the owner(s) of each third party copyrighted matter to be included in my thesis or dissertation and will supply copies of such upon request by my school. I acknowledge that RU ETD and my school will not distribute my thesis or dissertation or its abstract if, in their reasonable judgment, they believe all such rights have not been secured. I acknowledge that I retain ownership rights to the copyright of my work. I also retain the right to use all or part of this thesis or dissertation in future works, such as articles or books.
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2021-01-31
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2099-12-31
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Access to this PDF has been restricted at the author's request.
Copyright
Status
Copyright protected
Availability
Status
Open
Reason
Permission or license
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2020-12-02T06:52:36
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2020-12-02T06:52:36
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