Compliance with a Nurse-driven Hypoglycemia Protocol: Time from Hypoglycemia Event to Euglycemia

Abstract

Practice Problem: Hypoglycemia is a known complication of diabetes mellitus and is considered one of the top three adverse drug events by the U.S. Department of Health and Human Services (2019) because it is common, clinically significant, measurable, and preventable. PICOT: The PICOT question that guided this project was: In non-critical hospitalized adult patients on medical-surgical units with documented HGEs, how does active surveillance for strict adherence to a nurse-driven hypoglycemia protocol, compared to no surveillance, affect the time from hypoglycemia to euglycemia? Evidence: Treatment of hypoglycemia is commonly inconsistent and prolonged; however, active surveillance and monitoring of a nurse-driven protocol by diabetes nurses has improved hypoglycemia protocol adherence and the time from a hypoglycemia event to euglycemia. Intervention: Education regarding the physiological effects of hypoglycemia and treatment was provided to medical-surgical nurses. Active surveillance/medical-surgical unit rounding was instituted by a registered nurse diabetes clinical coordinator focusing on adherence to the established nurse-driven hypoglycemia protocol. Outcome: The DCC rounding proved clinically significant as adherence to each component of the protocol improved. The time from HGE to euglycemia improved, and a statistically significant improvement in nursing knowledge related to the physiological effects of hypoglycemia and treatment was identified. Conclusion: Continued emphasis on nurses’ adherence to the hypoglycemia protocol through DCC surveillance and additional innovative practices is necessary for improved patient outcomes.