Our inpatient diabetes program
The goal of the Inpatient Diabetes Program at The Ohio State University Medical Center is to improve diabetes care through research, education and patient care.
Many years ago our program harnessed the capability of the electronic medical record to improve safety and optimize diabetes care. These efforts included the implementation of standardized insulin order panels and order sets, flexible mealtime insulin dosing using the carbohydrate counting technique, a universal insulin drip protocol ,and numerous inpatient diabetes management guidelines. We have developed a hypoglycemia management guideline and a concentrated insulin policy. Our insulin pump and continuous glucose monitoring policy and accompanying order set facilitates the safe use of diabetes technologies in conjunction with our inpatient team. More recently we have developed discharge order set to improve the transition from hospital to home.
We collaborate heavily with multiple disciplines, including Inpatient Pharmacy, Evidence Based Medicine, Nursing, Critical Care Units and numerous subspecialty services to guide and standardize care, evaluate outcomes, educate clinicians and hospital staff, and oversee patient education. In addition, our inpatient consult teams provide daily co-management and consultative services.
Diabetes Unit Resource Nurses (DURNs)
Diabetes Unit Resource Nurses (DURNs) are the clinical nurses in the hospital with added resources and knowledge related to the care of the diabetic patient. They are key to helping the inpatient diabetes team meet the target goals for blood glucose control. DURNs meet quarterly and are leaders on the nursing units who directly impact change and positive outcomes with diabetes care. DURNs help ensure that patients with diabetes receive inpatient education for improved glucose control.
Changes DURNs have helped bring about include updated target glucose ranges, carbohydrate counting, insulin devices, insulin drip protocol revision and diabetes guidelines implementation.
Research efforts include randomized controlled trials comparing glucose lowering therapies or approaches to therapy, analyses of quality improvement efforts and hospital outcomes, as well as interventions to provide patient centered care and promote community engagement.