Description
Strategies to Reduce the Incidence of Hypo & Hyperglycemia in the Acute Patient
Critical Interventions for the Patient in Crisis
Nancy Moline – Improving Diabetes Management: Tools for the Nurse
Treating Special Populations: Easy to Use Formulas
The Importance of Dosing & Timing
Tips & Tools You Can Put into Practice the Next Day
Until recently, glucose control in the hospital setting was largely ignored even in patients with a diagnosis of diabetes. We didn’t realize 1 out of every 3 patients we were caring for was potentially suffering the consequences of uncontrolled hyperglycemia and, worse, these unknown patients were experiencing higher mortality rates after discharge. Bottom line, we MUST do better and you, the bedside nurse, play a critical role in identifying and managing your hypo and hyperglycemic patients.
This seminar will address issues you face in the hospital and give answers to questions you won’t find in any textbook. Imagine being able to look at a single flowsheet and understand exactly why your patient continues to experience hypoglycemia, or persistent hyperglycemia. Expert, Nancy Moline, RN, M.Ed., CDE, will share with you the management techniques and tips she has developed through her extensive experience and increase your understanding of the complexities of diabetes. You will leave this seminar with new tools and formulas to improve the outcomes of your patients with and without diabetes diagnosis.
Handouts
Manual ZNM077340 (6.01 MB) 63 Pages Available after Purchase
Outline
Glycemic Targets for Hospitalized Patients
Clear interpretation of AACE & ADA guidelines
Adjusting limits for the critically ill patient
Non-critical patients: How high is too high
Recognizing Symptoms of Hypoglycemia
Hypoglycemic unawareness: How are we missing this?
Interventions that change outcomes
15/15 Rule
Timing and Dose: The good, the bad, the ugly
IV dextrose
Glucagon
Reducing Incidence of Hypoglycemia
Finger sticks & technique – it does matter!
Critical timing for pre-meal & correction insulin
The nurse’s role in ensuring carbohydrate-consistent meals
Symptoms & Critical Interventions for Hyperglycemia
The differences of DKA & HHNK
Diabetic Ketoacidosis
A complex metabolic process
Identifying the patient at risk
Managing fluid replacement to avoid complications
Insulin drips
Critical labs & acute management
Nursing Management of HHNK
Identifying the symptoms
Don’t forget your ABCs
Common laboratory pitfalls
Restoring electrolyte balance
Consequences of Acute Hyperglycemia
Addressing & managing new wound infections
The dangers of:
Platelet abnormalities
Inflammatory cytokine response
The patient & the facility at risk:
Poor patient outcomes
Readmissions
Increased length of stay
Insulin resistance
Treating Special Populations Using a Simple Formula
The patient newly prescribed steroids
Adjusting for tube feedings
TPN: Understanding the effects for the diabetic patient
Considerations for patients on R-U-500 insulin
Insulin for Improved Glucose Control
Type 1 vs. Type 2 guidelines
Action times of insulins
Calculating Basal/ Bolus Insulin
Miami 4/12 Rule
Correction scales based on insulin sensitivity
Oral Agents in the Hospital Setting
NPO vs eating status
Precautions for Metformin
Safety Issues with Managing Insulin Pumps
Patient exclusion criteria
Recognizing pump problems
When to remove pumps
System Improvements Positively Impacting Patient Outcomes
Standardized correction scales based on insulin sensitivity
Standard protocols for treating hypoglycemia
Physician order sets for insulin initiation
Carbohydrate labels on meal trays/snacks
Putting It All Together
Case Studies: What went right and what went wrong
Solving problems using the glucose accordion flowsheet report
