Jones Memorial Hospital Lauren Morris, RN - NYSPFP · Lauren Morris, RN . Clinical Information...
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Medicine of the H ighest O rder Jones Memorial Hospital Glycemic Control Committee Started 4/19/16 Glycemic Control Lauren Morris, RN Clinical Information Analyst Cheryl Feeman-Macafee, MBA, R.H.I.A, C.P.H.Q. Director, Quality Management September 13, 2016
Transcript of Jones Memorial Hospital Lauren Morris, RN - NYSPFP · Lauren Morris, RN . Clinical Information...
M e d i c i n e of
t h e H i g h e s t O r d e r
Jones Memorial Hospital
Glycemic Control Committee Started 4/19/16
Glycemic Control
Lauren Morris, RN Clinical Information Analyst
Cheryl Feeman-Macafee, MBA, R.H.I.A, C.P.H.Q. Director, Quality Management
September 13, 2016
Outline Jones Demographics
Goals of Committee
Committee Members
Main Focus
Successes
Challenges
Next Steps
Q & A
Jones Memorial Hospital, located in beautiful southwestern New York State, is a 70-bed acute care facility serving all of Allegany County, as well as western Steuben County and
northern Potter County, PA.
Cardiopulmonary Services Diabetes Center Emergency Department Inpatient Care Jones Memorial Medical Practices Laboratory Services Maternity Women’s Health Services
Medical Imaging Certified Nurse Midwife Nutritional Therapy Occupational Medicine Orthopedics Rehabilitation Services The Sleep Center at Jones Memorial Hospital Surgical Services
Jones Memorial Hospital
Glycemic Control Committee Started 4/19/16
Glycemic Control Committee
Started 4/19/16
Goals of Committee
-To improve glycemic control in our inpatient care setting for not only better patient outcomes but to be compliant with
regulations that are forthcoming
Period Hospital RaNYSPFP Ra HospitalsJan-16 79.31 56.9 61Feb-16 87.88 56.15 57Mar-16 77.42 57.78 52Apr-16 71.43 57.18 53
May-16 68.97 59.6 45Jun-16 70.37 54.79 40
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Committee Members Dr. William Coch –Medical Director Dr. Bruce Portner – Hospitalist Erin Frank PA – Physician Assistant Brenda Torrey RN, CDE – Case Manager/Certified Diabetes Educator Erika Zerkowski MS, RDN, CDE, CDN – Registered Dietitian/Certified Diabetes Educator Cherrie Macafee MBA, CPHQ, RHIA – Director of Quality Management Donna Bliven RNC, BSN, MHA – Vice President Patient Care Services/CNO Colleen Truax RN, BSN – ICU Manager/Cardiac Pulmonary Rehab Coordinator Lauren Morris RN – Clinical Information Analyst Kerry Clark PharmD – Clinical Pharmacist Betty Guinnip RN, BSN – Director of Staff Development Anne McCormick , RN, Manager of Med-Surg Beth Weekley, RN-Med-Surg Nurse Jamie Ross, RN-Clinical Leader Linda Pritchard, RN-ICU Ramonia Mccann, RN- Director Surgical Services
Main Focus of the Committee
1) Establish electronic order sets for MD providers to include all “gold standards” for basal/bolus implementation
2) Update hypoglycemia protocol and create electronic order set
3) Create and implement electronic order set for patient own insulin pump
4) Create and implement electronic order sets for insulin drip protocols
5) Educate staff on glycemic control and new policies/protocols
6) Improve transition of patient medication administration to home/community
Successes
*Implemented electronic order set in Meditech for MD providers to easily order basal/bolus regimen for inpatients. -Created new corrective scale based off TDD of insulin -Includes rules to prevent med errors *Created diabetic management special panel in EMR for providers and interdisciplinary staff *Implemented patient’s own insulin pump electronic order set for MD providers *Implemented hypoglycemia protocol electronic order set for nursing
Successes Cont…
*Implemented insulin drip electronic order sets for MD providers *Educated nursing staff and MD providers on importance of glycemic control and new order sets *Interdisciplinary collaboration, support, participation *Enthusiasm and eagerness of nursing staff for better control of patient glucoses
Challenges
*Working within parameters of Meditech to develop order sets that met MD providers “user friendly” request *Discussion of switching from community vials of insulin on the patient care floor to utilizing individual patient insulin pens *Nurse education – timing of trainings, how best to train (classes vs. super users), census fluctuations *Timing of nutritional insulin administration and meal delivery - especially breakfast
Next Steps – Looking Forward…
*Creation of nursing documentation for when patient has own insulin pump *Continue to update and improve order sets as implementation continues to role out to providers *Begin electronic order sets for perioperative hyperglycemia management *Re-visit the use of insulin pens in the hospital setting *Create annual competency for glycemic control *How to best monitor glycemic control – through reports, daily huddle, and staff *Nursing “friendly competition” for best glycemic control and advocacy of patient
Thank You
Q & A
