Managing Glucose Levels in Hospital Patients

Bridget Everhart, RN, MSN, ACNP, CDE and Stacy Seggelke, RN, MS-CDE,, ACNS-BC, BC-ADM

 

Overview:

Over the last 25 years, more than twice as many patients have been discharged from U.S. hospitals with a diagnosis of diabetes mellitus (DM). Typically, about 25% of hospital patients have a diagnosis of DM or hyperglycemia during their hospital stay. Historically, managing hyperglycemia in the hospital has been seen as secondary to managing the admitting diagnosis. But a growing body of literature supports targeted glucose control, because hyperglycemia in hospital patients can prolong lengths of stay, increase the infection risk, and raise mortality. This article, which addresses glucose management in hospital patients
who aren’t critically ill, is based largely on guidelines from the American Diabetes Association (ADA) and the American Association of of Clinical Endocrinologists (AACE).

Purpose/Goal: To provide nurses with the information they need to better manage glucose in non-critically ill patients.


Objectives:

1. Identify the role of subcutaneous insulin in glucose management for noncritically ill inpatients.
2. Describe how to manage hypoglycemia.
3.Discuss glucose management in patients with conditions that can trigger hyperglycemia.


Author:

Bridget Everhart, RN, MSN, ACNP, CDE is a registered nurse and acute care nurse practitioner with more than 15 years experience in diabetes care and 25 years as a registered nurse. She has provided care for patients with diabetes in an outpatient endocrine practice and in the inpatient, hospital setting. She has also been a clinical assistant professor in a university setting teaching graduate and undergraduate students and has more than 20 years of teaching experience in a variety of topics, especially including diabetes, other endocrine disorders, fluid and electrolytes, and critical care topics. She is currently the inpatient diabetes educator at UCH where she teaches nurses, physicians, and other staff about glucose management and insulin use. She also teaches patients in diabetes self management. She monitors glucose control and insulin practices in the hospital, and works with the UCH DM Program administrator and director to develop and revise insulin protocols, policies, and guidelines and she implements these protocols throughout the hospital. Stacey A. Seggelke, RN, MS, CDE, ACNS-BC, BC-ADM is a Diabetes Clinical Nurse Specialist at the University of Colorado School of Medicine. She was employed as a diabetes educator for 7 years and is a member of Inpatient Glucose Management team since 2008. She has published numerous articles on inpatient diabetes care.

The planners and author of this CNE activity have disclosed no financial relationships with any commercial companies pertaining to this activity.


Contact Hours: 1.6

Expiration Date: 9/30/2015

Pharmacology Hours: 1

 

Member Price: $15.00
Non-Member Price: $20.00

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