Evidence Based Practice Activity

1. Why did you select this article?

I chose this article because I admit to not fully understanding diabetes and the
insulins or oral meds given. I want to try to learn more about this. By my
understanding of insulins given and time frames of administration, I can better care
for my patients. In addition to better caring, I can also be a better patient educator. I
found this article to be relatable to clinicals. From facility to facility in clinical, I have
noticed that some delegate accuchecks to PCAs, others have policies and procedures
specifically stating it is the nurses responsibility. Regardless of who completes the
task of obtaining an accucheck, it is important to note the time of accucheck, time of
meal and time of insulin administration. It is important, especially when giving a
short-acting insulin within 30 minutes of the accucheck and meal is available at that
time.

2. How will you apply information in this article to your nursing practice?
I would apply this by being very mindful when assessing an accucheck and
administering insulin. After reading this article and noting that there is evidence of
change in the accucheck reading if a long amount of time has elapsed between it, I
feel as though I would be much more cautious when giving insulin. I may even
consider rechecking the accucheck as the meal arrives to the patient. I would make
sure I was using assessment skills rather than being task oriented and only obtaining
accuchecks at a specific time regardless of meal being available. I want to be as safe
of a nurse as I can be. By implementing and using this information from the article, I
can do so.

3. Compare and contrast the information in this article to observations you made on
the unit.
Between the different clinical sites, I have seen different protocols and policies being
followed relating to accuchecks and insulin administration. Some facilities practice as
the article states, obtain accuchecks at specific time regardless of when meals arrive.
In the meantime, it is not 30 minutes after an accucheck to administer insulin, it is
actually hours. At other facilities, I have seen it practiced in a way that the
accucheck, meal delivered and insulin is all completed at the same time. This may be
a safer practice to do. That way the accucheck is much more accurate and insulin
being given from a sliding scale is reflective of that. I can conclude that it is best
practice to obtain the accucheck as the meal arrives. Insulin should be given at this
time only if the patient is certain he/she will complete the meal or how much will be.

Article Used:
Trotter,B.,Conaway,M.R.,&Burns,S.M.(2013).RelationshipofGlucoseValuesToSlidingScale
Insulin(CorrectionalInsulin)DoseDeliveryandMealTimeInAcuteCarePatientsWithDiabetes
Mellitus.MEDSURGNursing,22(2),99.