Date of Award

8-1-2015

Document Type

Thesis

Degree Name

Doctor of Nursing (ND)

First Advisor

Dr. Cheryl Fuller

Second Advisor

Dr. Michael Adler

Third Advisor

Dr. Brenda Hage

Abstract

The population of individuals with diabetes is expected to rise along with a rise in the use of insulin therapy to control hyperglycemia and prevent diabetic complications. Insulin therapy is implicated as one of the leading causes of hypoglycemia, a potentially life-threatening adverse drug event. Hypoglycemia is recognized by patients and clinicians as the greatest barrier to achieving adequate glycemic control and it causes physical, psychosocial, financial, and safety concerns for individuals, their families, communities and health care systems. Hypoglycemia often causes insulin requiring diabetics to develop a fear of hypoglycemia, a complex phenomenon that manifests as avoidance of hypoglycemia or near normal euglycemia thus triggering hyperglycemia and increasing risk. The fear and risk of hypoglycemia requires attention by clinicians in order to assist patients in self-management. The purpose of this evidence based project was to add to clinical knowledge and demonstrate how the application of best practice strategies can be translated into real world clinical practice to improve quality and safety. All insulin requiring adults evaluated by the advanced practice nurse were provided education in accordance to best practice standards. Sixty participants were queried pre-intervention and post-intervention with the FH-15 Survey and a hypoglycemia incidence survey. The data was comparatively analyzed. Outcomes demonstrated that self-management education effectively reduced fear of hypoglycemia and incidence of hypoglycemia; however, the intervention was statistically significant in reducing fear of hypoglycemia only. Additional scholarly inquiry regarding the topic is recommended.

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