Date of Doctor of Nursing Practice Project Completion

Fall 12-30-2025

Faculty Advisor

Susan Stafford

Abstract

Purpose

The purpose of this quality improvement project was to improve compliance with the administration of scheduled short-acting insulin within 30 minutes of point-of-care blood glucose testing among hospitalized diabetic patients.

 

Background

This project was implemented in an inpatient hospital unit caring for patients with diabetes who require scheduled short-acting insulin. Internal audit data showed that compliance with administering insulin within 30 minutes of blood glucose testing was approximately 60%, indicating an opportunity to improve workflow and care coordination.

 

Methodology

The Plan-Do-Study-Act (PDSA) quality improvement method was used to guide the project. Baseline data were collected from electronic health record reports measuring the timing of insulin administration following blood glucose testing. Staff were educated on the importance of timely insulin administration before implementation and periodically during the project. Communication between patient care assistants, nurses, and unit clerks was improved to better coordinate glucose monitoring, meal delivery, and insulin administration. Compliance data was monitored throughout the project period.

Results

Compliance with timely short-acting insulin administration averaged 60–61% at baseline. During the implementation period, compliance improved to 77.5%, representing a 17% absolute increase and approaching the project goal of 80%. Hypoglycemic events decreased after implementation, while hyperglycemia rates remained stable.

 

Implications

Improving interdisciplinary communication and standardizing workflow processes may increase the reliability of timely insulin administration in hospitalized patients. The workflow changes introduced during this project may provide a sustainable approach to improving inpatient glycemic safety. Similar communication strategies may also be applied in other inpatient units to support safer medication timing and care coordination.

Keywords

quality improvement, insulin administration, inpatient diabetes management, glycemic control, workflow communication.

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