Title

Reducing Diabetic Ketoacidosis Readmissions with a Hospital-School-Based Improvement Partnership.

Document Type

Article

Publication Date

3-2023

Abstract

Diabetic ketoacidosis (DKA) is the leading cause of morbidity and mortality in pediatric type 1 diabetes mellitus (T1D). Baseline data showed 139 of 182 DKA readmissions (76.4%) were due to missed basal insulin dosing. The team used quality improvement tools to implement a process change around basal insulin. The project utilized insulin degludec and school-based nurses when missed basal insulin was noted as a main driver for readmission. The DKA readmission rate averaged 5.25 per month from January 2017 to April 2019. The rate decreased to 3.64 per month during the intervention from May 2019 to March 2020, a 31% reduction over 11 months. This standardized approach for patients with T1D readmitted with DKA, using a school-based intervention and insulin degludec, reduced the number of DKA readmissions. This method is safe and effective for lowering DKA readmissions due to missed basal insulin in areas with reliable school nursing.
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Publication Title

American journal of medical quality : the official journal of the American College of Medical Quality

Volume

38

Issue

2

First Page

93

Last Page

101

Comments

online ahead of print

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