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The Implementation and Evaluation of an Evidence-Based Protocol to Treat Diabetic Ketoacidosis A Quality Improvement Study

The Implementation and Evaluation of an Evidence-Based Protocol to Treat Diabetic Ketoacidosis A... This retrospective observational quality improvement study was conducted to determine whether an evidence-based protocol for the treatment of diabetic ketoacidosis improved patient outcomes in our academic medical center. This study evaluated fidelity of providers to the protocol, as well as time to resolution of diabetic ketoacidosis as measured by closure of the anion gap (AG). Other secondary outcomes included time to intravenous fluids, time to potassium replacement, and rates of hypoglycemia and hypokalemia. Two cohorts including historical (N = 41) and current (N = 37) were compared to evaluate the effectiveness of the protocol. There were no differences between group demographics at baseline. After implementation of the protocol, 43.2% of patients were treated using full protocol fidelity, 21.6% were treated with partial fidelity, and 35.1% were not treated using the protocol. Although none of the outcomes reached statistical significance, patients in the current group who were treated with full protocol fidelity had an average time to AG closure that was 3 hr less than those who were not treated according to the protocol, and an average time to potassium replacement that was 2 hr less. When comparing the historical cohort with the patients treated with full protocol fidelity, there http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Advanced Emergency Nursing Journal Wolters Kluwer Health

The Implementation and Evaluation of an Evidence-Based Protocol to Treat Diabetic Ketoacidosis A Quality Improvement Study

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References (14)

Copyright
© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
ISSN
1931-4485
eISSN
1931-4493
DOI
10.1097/TME.0000000000000021
pmid
24785671
Publisher site
See Article on Publisher Site

Abstract

This retrospective observational quality improvement study was conducted to determine whether an evidence-based protocol for the treatment of diabetic ketoacidosis improved patient outcomes in our academic medical center. This study evaluated fidelity of providers to the protocol, as well as time to resolution of diabetic ketoacidosis as measured by closure of the anion gap (AG). Other secondary outcomes included time to intravenous fluids, time to potassium replacement, and rates of hypoglycemia and hypokalemia. Two cohorts including historical (N = 41) and current (N = 37) were compared to evaluate the effectiveness of the protocol. There were no differences between group demographics at baseline. After implementation of the protocol, 43.2% of patients were treated using full protocol fidelity, 21.6% were treated with partial fidelity, and 35.1% were not treated using the protocol. Although none of the outcomes reached statistical significance, patients in the current group who were treated with full protocol fidelity had an average time to AG closure that was 3 hr less than those who were not treated according to the protocol, and an average time to potassium replacement that was 2 hr less. When comparing the historical cohort with the patients treated with full protocol fidelity, there

Journal

Advanced Emergency Nursing JournalWolters Kluwer Health

Published: Apr 1, 2014

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