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Applying quality improvement methods in a hyperbaric oxygen program: reducing unnecessary glucose testing.

Sarah L Stevens1, Atsushi Sorita1, Anthony J Narr1

  • 1Division of Preventive, Occupational and Aerospace Medicine, Mayo Clinic, Rochester, Minnesota, U.S.

Undersea & Hyperbaric Medicine : Journal of the Undersea and Hyperbaric Medical Society, Inc
|August 2, 2017
PubMed
Summary
This summary is machine-generated.

A quality improvement project standardized glucose checks for diabetic patients in hyperbaric oxygen (HBO₂) therapy. This initiative reduced glucose monitoring frequency while enhancing protocol compliance and patient safety.

Keywords:
glucose check,diabeteshyperbaric oxygen

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Area of Science:

  • Hyperbaric Medicine
  • Quality Improvement Science
  • Endocrinology

Background:

  • Diabetes mellitus is a common comorbidity in patients requiring hyperbaric oxygen (HBO₂) therapy.
  • Standardizing glucose monitoring protocols is crucial for patient safety and effective treatment in hyperbaric settings.
  • Existing protocols for glucose checks in diabetic patients undergoing HBO₂ therapy may lack standardization, potentially impacting care quality.

Purpose of the Study:

  • To describe the implementation and impact of a quality improvement (QI) project focused on improving and standardizing glucose checks for diabetic patients receiving HBO₂ therapy.
  • To develop and test a nurse-led protocol to optimize glucose monitoring frequency and adherence.
  • To evaluate the effect of the QI intervention on glucose check frequency, protocol compliance, and patient safety outcomes.

Main Methods:

  • A prospective cohort study design was employed, utilizing the Model for Improvement framework.
  • Multiple Plan-Do-Study-Act (PDSA) cycles were conducted over four months by a multidisciplinary team (nurses and physicians).
  • A nurse-led protocol for glucose monitoring was developed, implemented, and prospectively tested in patients undergoing HBO₂ therapy.

Main Results:

  • Implementation of the QI protocol led to a significant decrease in glucose checks per session by 37.7% (from 2.84 to 1.77, P<0.001) compared to baseline (N=332).
  • Compliance with the new protocol (97.3%) was significantly higher than with the previous protocol (84.2%, P<0.001).
  • No instances of symptomatic hypoglycemia were reported following the protocol's implementation.

Conclusions:

  • A multidisciplinary quality improvement project successfully improved the management of diabetic patients undergoing HBO₂ therapy.
  • The implemented QI project demonstrated feasibility within a hyperbaric practice, enhancing patient care standardization.
  • Further QI training and project implementation are recommended for hyperbaric programs to foster a culture of safety and continuous improvement.