Purpose: The purpose of this project is to increase compliance with a hypoglycemia guideline to improve patient care of those experiencing hypoglycemia in the emergency department at a large academic medical center.

Methods: In order to gain an understanding of current compliance to the hypoglycemia guideline, for four weeks all hypoglycemia events were analyzed looking at eight measures (Table) pre-intervention (n=43), and this step was repeated post intervention(n=39). The intervention period included one month dedicated to educating the staff about the guideline, implementing visual aids throughout the department, and having a staff member act as a glucose champion for all blood glucose related questions.

Results: Overall there was low compliance to the protocol initially, but after the intervention there was improvement in all eight areas analyzed (Figure). Areas that showed the most improvement included: immediate blood glucose recheck (9.1% to 23.1%), 15 minute recheck (29.5% to 51.3%), follow-up with a carbohydrate (40.9% to 71.8%), and hourly recheck x3.

Conclusion: Increasing awareness of the hypoglycemia guideline through education, and visual aids led to increased compliance. Anecdotally staff found having a glucose champion to be the most helpful in adhering to the guideline and delivering best care. Going forward having at least one assigned RN as a glucose champion is recommended.

T.A. Clark: None. L. Bak: None.

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