Date of Award

1-1-2020

Document Type

Open Access Thesis

Degree Name

Doctor of Nursing Practice (DNP)

Department

Yale University School of Nursing

First Advisor

Jessica Coviello

Abstract

Insulin is the most common medication used to treat patients with diabetes in the inpatient setting. Among injectable drugs, insulin has the highest risk for error, which may result in dire consequences for patients. Registered nurses are among the main groups of clinicians that work with insulin, yet they may sometimes lack the comprehensive knowledge associated with inpatient diabetes care and insulin. The purpose of this project is to educate registered nurses at a major academic medical center about inpatient diabetes management focused on insulin therapy. The educational content was based on a medical error analysis and a current inpatient diabetes module of another major medical institution. The content included case studies and was presented as an interactive online module and evaluated using a pre-and posttest and satisfaction survey. The most common insulin-related medical errors found were (1) omission of rapid acting correction insulin, (2) omission of basal insulin, (3) omission of rapid acting insulin and, (4) administering bolus rapid acting insulin when patients are NPO. Pre-test to post-test scores on the training went from 49% to 71%. This project demonstrates a knowledge gap in inpatient diabetes management specific to use of insulin in registered nurses as well as the efficacy of an online, interactive cased-based module to improve knowledge and fill this gap.

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