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Ryan De La Merced, DNP, CRNA
DNP: Southern California CSU DNP Consortium, Kaiser Permanente School of Anesthesia
BSN: Mount Saint Mary's University
Perioperative Glycemic Management of Diabetic Patients
Project  
Abstract:
Uncontrolled perioperative glucose levels have been demonstrated to affect outcomes of Type 2 diabetics and non-diabetics undergoing surgical procedures to a lack of standardized protocols to manage hyperglycemic events, patients are at increased risk of infection, hospital lengths of stay, morbidity, and mortality (Cho et al., 2018; Duggan & Chen, 2019; Joslin Diabetes Center, 2019; Nair, Horibe, et al., 2016; Vogt & Bally, 2020). Appropriate perioperative blood glucose management is critical to enhancing health outcomes, shortening hospital length of stay, and reducing the need for hospital readmission (ADA, 2020). METHODS: Retrospective chart audits were conducted as part of a quality improvement project. Proper adherence to a glycemic management protocol was compared before and after education was provided to anesthesia providers. Data were obtained from the electronic health records of patients with type 2 diabetes mellitus who underwent general anesthesia at a regional medical center hospital in Southern California. A total of 100 preintervention and 100 postintervention charts were included in the data collection sample. INTERVENTION: Optimal control of perioperative blood glucose levels is facilitated by a detailed, evidence-based protocol that clinicians can efficiently comprehend and employ. The Emory University School of Medicine Perioperative Insulin Management Protocol was used to educate anesthesia providers at a Southern California medical center. Retrospective chart audits were done to assess provider patterns of diabetic care and patient glycemic outcomes before protocol education and post-education. The efficacy of educational outcomes can be evaluated by performing chart reviews and identifying deviations from recommended protocols and suboptimal glycemic outcomes.
Team Leader: Edward Waters, DNP, CRNA
Team Member(s): Manal Alatrash, PhD, RN
Group Member(s): Niko Africano, DNP, CRNA and Gustavo Leor, DNP, CRNA

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