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DHT2 capstone - Research Paper Example

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Poor Glycemic Control in ICU Patient DHT2 TASK 1 Ambika Chacko Western Governors University Topic Diabetic patients admitted to the ICU must have their blood sugar carefully monitored as part of their treatment. Implementing the existing clinical protocol includes assessing the clients’ health upon admission and consulting with the electronic medical records to identify their medical histories of glycemic control…
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Download file to see previous pages When blood sugar levels rise, risk of infection increases, and organs can fail. Morbidity and mortality result. Careful glycemic control is crucial to a diabetic’s survival and recovery. Nurses can take the lead in improving the implementation of ICU clinical protocol, and their critical thinking skills are invaluable for determining such protocol (Plost, Nelson, 2007, p 155). What obstacles prevent ICU nurses from full compliance with protocol for glycemic control during the first 48 hours of a diabetic patient’s stay in the ICU, and what steps will raise compliance? A2.Participants The participants in this study are registered nurses with bachelor’s degrees and at least two years of experience in the ICU, and they work together in the ICU of a community hospital. Most work full time, but several are part time. Nurses with less than two years of experience in the ICU are excluded. They range in age from 25 to 59; older nurses have been in the ICU for decades and younger ones seem poised for long careers, as well. Such longevity produces expertise, but also precludes innovation. These nurses come from different nationalities and ethnicities. Although their educational level are similar, their learning styles differ markedly. Also, what motivates each of them has an impact on the implementation of protocol. They have not been involved in developing protocol. The researcher observed a lack of compliance with protocol for glycemic control in the ICU. B1. B . Outline the problem: During the first 48 hours after ICU admittance, patients have poor glycemic control because the policy and protocol for blood glucose monitoring is not followed. In this community hospital, it has been observed the patients’ blood glucose level during the first 48 hours of their admission is high and is not being managed according to the national standard. The main problem is to identify the reasons nurses do not comply with the treatment plan. What causes nurses to not follow the protocol? And how can we improve the compliance? B3.Causes of the problem Compliance with new legislation costs money. Examining and tracking the quality of care is a financial concern. In facilities with strict budgetary restraints like this one, pressures are enormous to delay or deny compliance. The facilities many not be able to comply in every aspects of patient’s care. This ICU does not have an internal audit nurse which could have been befitted to compliance program. Before something has become a clinical concern, compliance programs are especially ineffective. “ The better trained the staff, the better the quality of care and the more compliant a facility will be (Abell,T,2011)”. All staff members need to respect compliance with regulations, a fact which is not observed in this ICU. Staff nurses are not sure if the protocol and previous training they have received was effective. How was the follow up? Staff is not aware of any. This ICU must ensure qualified educators are performing the training, and the protocol has to take into account the nurses’ level and the needs of the community. Interventions always have to be meaningful which is not observed in this ICU. Another concern nurses feel is that they are very busy in ICU with the acute care needs of the patient; there is not enough time, or not enough staff. Nurses believe ...Download file to see next pages Read More
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