Date of Degree

12-2020

Document Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)

Program

Nursing

Advisor

Danielle Gunter

Advisor

Maria S. Rayas

Abstract

Background: Insulin pumps are essential in the management of type 1 diabetic pediatric patients because of their versatility in meeting the developmental needs of childhood and adolescence. Summary of the Evidence: There is lack of evidence for standardized pump initiation program in pediatric patients (ADA, 2019). Moreover, adverse events from insulin pump misuse, such as diabetic ketoacidosis, arise from lack of anticipatory guidance of pump management and troubleshooting (Evert et al., 2016; Grunberger et al., 2014, Wheeler et al, 2014). Project Purpose: The purpose of this quality improvement (QI) project was to reduce and prevent adverse outcomes of insulin pumps secondary to an inefficient initiation process, management, and patient/family understanding. Project Objectives: Objectives of this QI were: the implementation of a streamlined initiation process, assessment of patient knowledge through an additional education session including a pre-and post-test patient skills questionnaire, and to decrease adverse effects related to new insulin pump use. Results: 100% staff education was achieved, 67.5% of patients/families attended the new education session achieving an average score of 80% or higher on the skills questionnaire, and adverse effects related to new insulin pump usage decreased from a rate of 66% to 50% after implementation. Implications for Practice: Use of practice guidelines to implement a structured process for insulin pump initiation is a cost-effective strategy to promote patient ownership, improve patient knowledge, lower potential costs of clinic or hospital visits for adverse effects, and guide provider oversight in effective use of technology to improve patient outcomes and decrease barriers to care.

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