A Quality Improvement Project: Improving the Clinical Practice for Assessing Hemoglobin A1C on Admission in Diabetic Ketoacidosis Patients Admitted to the Intensive Care Unit

Author

Tiara LawsonFollow

Date of Award

Summer 2024

Document Type

DNP Executive Summary

Degree Name

Doctor of Nursing Practice (DNP) in Family Nurse Practitioner

Department

Nursing

Faculty Chair

Dr. Jessica Lockhart DNP

Preceptor

Dr. Kurt Bowman MD

Mentor

Dr. Ayanna Artis DNP

Abstract

Background: Diabetic ketoacidosis (DKA) is a life-threatening problem that affects people with diabetes. Early treatment and adherence to guidelines are crucial in preventing DKA. The American Diabetes Association (ADA) publishes annual guidelines for effective DKA management, and the Education Recognition Program National Benchmarks program can help maintain adherence to the published guidelines. Improving the intensive care unit (ICU) admission process enhances the quality of care to DKA patients and improves progress towards national benchmarks.

Purpose: This quality improvement project aimed to improve Hemoglobin A1C (HbA1c) evaluations in DKA patients admitted to the ICU.

Methods: The intervention of triggering HbA1c orders on patients admitted to the ICU with DKA was supported by Roy's Adaptation Model theoretical framework and the Leveraging Resources Model methodology. To implement this, a new HbA1c order was created in the electronic health record (EHR) to be triggered by providers when DKA patients are admitted to the ICU. The project compared no-HbA1c orders vs triggered HbA1c orders.

Results: The EHR prompt improved orders for HbA1c tests for patients with DKA admitted to the ICU, leading to a 2.5% increase in ADA compliance within three months.

Conclusion: Adding a prompt to the electronic health record is a cost-effective and efficient strategy for meeting national benchmarks in DKA management.

Keywords: diabetic ketoacidosis, intensive care unit, dka protocols, hemoglobin a1c

Recommended Citation

Lawson, Tiara, "A Quality Improvement Project: Improving the Clinical Practice for Assessing Hemoglobin A1C on Admission in Diabetic Ketoacidosis Patients Admitted to the Intensive Care Unit" (2024). Doctor of Nursing Practice Projects. 130.
https://digitalcommons.jsu.edu/etds_nursing/130