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Implementing a Glycemic Management Protocol with Surgical Patients

Masterson, Lisa M
http://orcid.org/0000-0002-8584-504X
http://rave.ohiolink.edu/etdc/view?acc_num=msjdn1619806592278265

Abstract Details

2021, Doctor of Nursing Practice, Mount St. Joseph University, Department of Nursing.
Surgical site infections (SSIs) are one of the costliest healthcare-acquired infections in hospital settings as they impact length of stay, patient outcomes, and hospital reimbursement. A recent increase in SSIs at a Midwestern community hospital gained the attention of the organizational leadership and spurred an initiative to decrease the SSI rates. The project team developed a foreground/background and targeted PICOT question to guide the review of the literature. Based on the results of the inquiry, an intervention targeting glycemic management of all surgical patients, except obstetrics and surgical patients under 16 years of age, was implemented as part of an evidence-based SSI prevention bundle. The project team chose the Iowa Model of Evidence-Based Practice to Promote Quality Care as the model for guiding the professional practice change. Using Lewin’s Change Theory as a framework, the project lead provided education to the surgical staff including perioperative nurses, certified registered nurse anesthetists, and the patient care assistant on stress hyperglycemia and glycemic management. Implementation of a glycemic management protocol for surgical patients began mid-November 2020. The goal was to improve hyperglycemia rates in this population of patients and assist in improving SSI rates. Data revealed that approximately 9% of patients had glucose values at or above 140mg/dL and required intervention. Standardized infection ratio (SIR) rates decreased on colorectal, total hip replacements, and coronary artery bypass grafts, abdominal hysterectomy rates were unchanged, and total knee replacement rates increased after implementation. This evidence-based quality improvement project demonstrated a correlation between glycemic management in surgical patients and improved SIR rates and improved patient outcomes.
Donna Glankler, DNP (Committee Chair)
Nursing
Surgical site infection; stress hyperglycemia; glucose management; surgery; healthcare-acquired infections

Recommended Citations

Citations

  • Masterson, L. M. (2021). Implementing a Glycemic Management Protocol with Surgical Patients [Doctoral dissertation, Mount St. Joseph University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=msjdn1619806592278265

    APA Style (7th edition)

  • Masterson, Lisa. Implementing a Glycemic Management Protocol with Surgical Patients. 2021. Mount St. Joseph University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=msjdn1619806592278265.

    MLA Style (8th edition)

  • Masterson, Lisa. "Implementing a Glycemic Management Protocol with Surgical Patients." Doctoral dissertation, Mount St. Joseph University, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=msjdn1619806592278265

    Chicago Manual of Style (17th edition)

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This open access ETD is published by Mount St. Joseph University Dept. of Nursing and OhioLINK.