58-LB: Coordination of Care to Reduce Hypoglycemia: Everybody Counts...Including Patients

The management of inpatient blood glucose control requires expertise among many healthcare providers. The purpose of this quality improvement project was to involve all processes of care, from patients calling to order a meal, to delivery at bedside. Learning about management of patients with diabetes in the hospital requires the participation of dietary personnel, dietitians, nurse assistants, nurses, physicians, diabetes educators, and patients. To reduce hypoglycemic events, physicians participated by chart reviews, evaluation of standardized order sets, improve insulin regimen to match intake. Nurses education was conducted via competencies on safe insulin management, annual updates, daily unit meetings. Regular feedback was provided by quality on glucometrics, timeliness of hypoglycemia management and monthly recurrent hypoglycemic events. Dietary participated by placing a 3x5 card “insulin tray tent card” at eye level, to encourage patient call the nurse when tray was delivered. Avoiding hypoglycemia requires coordination of insulin and meals and prompt response to concerns raised by the patients or their families. The inpatient setting is a rich learning environment, where also patients learn to improve clinical practice and facilitates a collaborative learning environment.