How Our Team Transformed Insulin Infusions and Why I’m Sharing It at Nursing Transformation 2025

A Nurse’s Perspective

My professional life has been entrenched in critical care nursing. As a former nurse educator and now a critical care Clinical Nurse Specialist, I focus on post cardiothoracic surgery patients, glucose management, and process improvement benefitting the bedside nurse. Nursing teams call me when the work feels complicated, and they need clarity at the bedside.

That drive to bring clarity to complex work is why I am heading to Nursing Transformation 2025 in Bloomington, Minnesota on September 29–30.

I am excited to share the story of how our team at Elkhart General Hospital rebuilt insulin infusion workflows for the front-line nurse, dramatically transforming practice producing amazing results.

Why This Conference Matters

Nursing is managing heavier and more complex patient loads amidst ongoing staffing challenges. Leadership has an obligation and an opportunity to create clarity and efficiency at the front line.

I believe we need to work smarter and not harder and working smarter requires the right clinical support tools that add immediate value.

I love research and innovation, but translating evidence to the bedside is difficult. If a change does not provide value added from the front-line nurse’s perspective, it will not stick; change will not be sustained.

We need clinical decision support tools and workflows that make best practice possible in real time.

How We Transformed Insulin Infusions at Elkhart General

Continuous insulin infusions used to feel more cumbersome than they needed to be. Paper protocols were confusing, variation crept in, and staff were left to remember too much.

Education and reeducation could not “fix” all the issues associated with traditional protocols focused on “one size fits some”.

We saw dismal baseline data with significantly high levels of hyper and hypoglycemia and that was unacceptable. Our DKA patients faced risks tied to too rapid glucose reductions and early discontinuation of insulin infusions.

To solve this problem, we rebuilt our processes focusing on clarity, efficiency, and safety at the bedside. We brought nurses and providers onto one shared pathway.

We adopted EndoTool IV to support patient-specific insulin dosing so the process could be clear, consistent, and safer to execute.

Once we implemented patient-specific insulin dosing, improved clarity and safer practice standards were immediately evident. Steps were clear, escalation was straightforward, and documentation matched what was happening in real time.

I onboard new nurses to use the EndoTool IV platform. The first time I walked staff through the algorithm workflow, they looked at me and said, “Is that it? You mean that is the dose?” I did not have to sell the product.

The innate clarity sold the algorithm; the immediate workflow improvement was the fuel needed to sustain the change.

My co-presenter, Charge Nurse, Krista Jewell, calls it “dummy proof” because the system removes guesswork. Clarity is calming for front line staff; EndoTool IV provides clarity.

The outcomes followed naturally. We reduced severe hypoglycemia to near zero, with almost 4 years at zero.

Stabilization in DKA, HHS, and EuDKA now occurs at an appropriate rate; too rapid of a BG reduction is no longer a grave concern because of algorithmic driven Staged Therapy.

Nurses feel calmer when assigned to patients with an insulin infusion. With consistent workflows and real-time documentation, CMS glycemic reporting becomes a byproduct of good care rather than a separate project.

What I Am Presenting at Nursing Transformation 2025

Session title: Dominating Continuous Insulin Infusions: Winning the War with Acute Blood Glucose Management

I will share the arc of our journey, from early champions and eroded processes to a nurse-led redesign that restored clarity at the bedside.

I will show how a shared pathway and patient-specific dosing changed daily work for nurses and providers, what our data looks like now, and the practical steps any unit can take to start without adding undue complexity.

My goal is to demonstrate how the right tools can really spark change for patients and nurses.

What I Hope to Learn

I want to see what other teams are doing to remove that “pebble in the shoe.” Nurses create workarounds because they tend to accept broken processes or that “pebble in the shoe”.

Some broken processes are harmless but add inefficiency and some add risk. I am looking for workflow solutions, large or small, that replace workarounds through better workflow design.

Nursing does not always have great vehicles to share process change. I hope we can change that together.

A Note to Peers

If you are on a path to improve glycemic management, stay the course. When you know the approach is evidence-based and will help your patients, stay the course. The work is complex, but with the right tools and a shared pathway, change becomes possible, and it can be sustained.

Join Me in Bloomington

If you are attending Nursing Transformation 2025, I would love to connect. Let’s compare what is working, trade simple checklists, and keep building care that is clear, consistent, and easier to sustain on every shift.