- July 17, 2014
As healthcare continues to change across America, many hospitals are interested in changing or incorporating new programs and technology as part of their general practices.
Unfortunately, all too often, these types of programs can end up failing. Not because the technology or programs are inadequate, but because the training and staffing necessary to implement change exceeds the amount of time set aside for it.
Through years of helping hospitals implement the EndoTool® Glucose Management System in their facilities, we have learned that preparing and training staff is just as important a step to deploying a new approach as the approach itself. Florida Hospital, a seven-campus system that is part of Adventist Health System, was well aware of this when it implemented EndoTool as part of its glucose management efforts in its cardiovascular intensive care unit (CVICU).
Before the hospital made a change, every CVICU nurse participated in mandatory training. The hospital further supported the change by ensuring that nurse technicians were on hand to help with bedside glucose measurements and one bedside glucose meter was available for every two patients.
The CVICU nursing staff was already familiar with titrating insulin infusions to an ordered blood glucose range, but many were skeptical about accepting computer-generated instructions and increased dosing amounts. Many also were not accustomed to providing IV insulin boluses along with the hourly rate adjustments. With detailed training and careful monitoring, the nursing staff became comfortable with EndoTool’s ability to individualize dosing in those rare patients whose insulin needs exceeded standard ranges.
By the time the nurses had six months of experience with the system, incidence of hypoglycemia decreased to zero and the majority of readings were between 70 mg/dL and 149 mg/dL. The success led the nursing staff to feel comfortable enough to reset the upper blood glucose limit to 140 mg/dL from 150 mg/dL.
This type of success can be experienced by all hospitals looking to change programs, processes and technology. They just need to plan and address the learning curve of the staff.