A quality improvement project for better glycemic control in hospitalized patients with diabetes.

Abstract

A quality improvement (QI) study was designed to improve nursing interventions that impact glycemic control in hospitalized patients with diabetes. The objective was to improve the timing of premeal insulin to allow a half hour lag time for regular insulin. An interdisciplinary planning team was established that included both medical and surgical units. Data were collected by concurrent review of electronic charts, evaluated monthly by management and the diabetes clinical coordinator, and shared with staff. This QI study increased staff nurses' awareness of the importance of their role in achieving better glycemic control for inpatients with diabetes. By the end of the study, the nurses delivered premeal insulin correctly 82% of the time on the medical unit, 65% of the time on the cardiac unit, and 61% of the time on the surgical unit. Even with concerted effort, however, it was difficult to consistently administer regular insulin with a half hour lag time in the hospital environment. By working together with the patient, family, and other staff, nurses can more consistently deliver premeal insulin at appropriate times to help improve glycemic control in the hospitalized patient with diabetes.