Ka Ram Lee
Hackensack University Medical Center in Hackensack, New Jersey, United States.
Abstract Title: Green Dome Project: Decreasing Hypoglycemia for Patients with Diabetes on a Heart Failure Unit
Biography: Ka Ram Lee have been a staff nurse at Hackensack University Medical Center for about ten years now, currently on the Heart Failure unit. I also serve on our hospital’s diabetes council, where I get to train our staff on diabetic patient care. I just finished my Master’s to become an Adult-Gerontology Nurse Practitioner. I’m really passionate about both cardiology and endocrinology, so I’m hoping to land an APN role in one of those specialties soon.
Research Interest: In October 2023, a 26-bed inpatient heart failure unit experienced a trend upward with an average of 4 out of 26 patients per month experiencing hypoglycemia, or lower than normal blood sugar. There was 61% compliance with insulin given within 30 minutes of checking blood sugar and 63% of meal consumption documentation was completed due to communication breakdown, workflow, and noncompliance of patients and family. In response, the diabetes team and assistant nurse manager initiated the Green Dome project to improve diabetes management and reduce hypoglycemia rates. Staff nurses, the diabetes nurse champion, and nurse assistant nurse manager collaborated with the diabetes educators and clinical nutrition manager to develop a quality improvement plan to use green meal tray covers for diabetic patients rather than the standard black covers. Upon delivery, a patient care technician or nurse would transfer the trays to the patients, along with a glucometer and test strips for blood sugar checks. Insulin would then be administered within 30 minutes of checking the blood sugar levels. After patients finished eating, their meal consumption was documented. The project leaders communicated the plan to all nursing staff and the nurse manager and reinforced the plan during the morning huddles. Educational tools, such as a chart for meal consumption documentation, were also created for both the nursing staff and patients. After the pilot project began, the rate of hypoglycemic episodes decreased to less than one patient per month for the next 3 months. Results included enhanced practices in checking blood sugar levels, 88% administering insulin within 30 minutes before patients started eating, and documented patients' meal consumption increased to 80%. The nursing staff learned the importance of consistently checking blood sugar levels, administering insulin, and monitoring and documenting meal consumption, all of which contribute to reducing the rate of hypoglycemic episodes.