Abstract:
Aim To examine nursing management of hypoglycaemic episodes in the hospitalised adult patient with Type 1 or Type 2 Diabetes Mellitus in the general medical/surgical wards at a secondary level hospital. Objective To describe hypoglycaemia treatment patterns in the adult inpatient by examining nursing adherence to the Northland District Health Board hospital hypoglycaemia protocol. Method A retrospective audit of 32 sets of treatment and progress notes identified nurses’ adherence to the protocol for management of inpatient hypoglycaemia . Results Adherence to the individual steps of the protocol was low. Nurses administered the recommended initial treatment in 40.4% of cases. Within 30 minutes of detection, 36.7% episodes were corrected. Medical staff were informed of hypoglycaemia in 11.4% of cases. This step achieved the lowest adherence. Nurses documented 87.7% of episodes. There was a high degree of recurrent hypoglycaemia (71.9%). Discussion It is critical to patient outcomes that the steps of the protocol are undertaken correctly. Failure to provide the recommended treatment resulted in some patients experiencing prolonged episodes. Whilst frequency of nursing documentation of episodes was high, critical assessment of causes and or a management plan were not routinely documented. Nurses did not routinely advise medical staff of episodes, consequently medical review of causes of hypoglycaemia and the management plan occurred infrequently. Failure to review management contributed to the high number of recurrent episodes.