Introduction and Objective: In hospitals, point-of-care (POC) glucose checks are often disconnected from meal delivery, delaying prandial insulin beyond the therapeutic window and contributing to poor glycemic control. We evaluated the feasibility of a structured implementation project aimed at reducing POC glucose-to-insulin administration times on an inpatient medical-surgical nursing unit.Methods: Nursing staff underwent brief training on insulin action, glucose regulation, guideline recommendations, and role/task clarification via staff meetings, daily pre-shift huddles, and unit flyers. A workflow bundle was developed in which meal delivery triggered a “POC check-now” cue using Epic Secure Chat; PCAs obtained POC glucose immediately after tray arrival; and nurses prioritized prandial insulin within 30 minutes of the POC result (institutional target). Lunchtime glucoses were evaluated at baseline and during implementation. Timestamped POC and prandial doses were manually collected from the EHR. Nurses scanned a QR code at end of shift to complete a survey inquiring about timing and barriers to insulin delivery.Results: At baseline (n=10), median POC glucose-to-insulin time was 133 min (IQR 116-175; range 83-293) and 0% were within ≤30 min. During implementation (N=36), median time decreased to 35 min (IQR 15-55; range 0-136) (133→35 min; −98 min; ~74% reduction). The proportion meeting the institutional target improved from 0% to 50% (18/36 ≤30 min). Reported barriers included patient preference/refusal, float staff unfamiliar with unit workflows, and competing priorities.Conclusion: A structured nursing training and workflow implementation program represented a feasible and scalable solution to reduce POC glucose-to-insulin administration times. Despite a large reduction in administration times, only 50% of insulin doses were administered within the institutional target, signaling the complexity and competing demands of diabetes care.
A. Mohamed: None. C. Harris: Consultant; Ended; Abbott Diabetes. E. Faulds: Research Support; Current; Dexcom, Inc. Research Support; Ended; Insulet Corporation. Other – Speaker; Ended; Medscape.
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