A consult by a physician or nurse is required for Diabetes Educator Services. The Diabetes Education Checklist for Insulin Administration (SN 7287) …

Written: April 1985 Nursing Policy: D-10 Reviewed: 3/87; 12/88; 2/90 LSUHSC - Shreveport, Louisiana Revised: 8/86; 4/92; 6/94; 2/95; 8/97; 9/98; 1/00; 4/02, 1/05; 7/05; 8/06; 12/06; 10/07 __________________________________________________________________________________________ DIABETES EDUCATOR Location: 10-H-5 Hours: 8:00 am to 4:30 pm, Monday - Friday Phone: Ext 57388, 57389 Inpatient Beeper: 0310 and Outpatient Beeper: 1808 Purpose: To provide additional educational services to meet the educational needs of the patient with diabetes and to provide inservice and support services for medical/nursing personnel who care for patients with diabetes

Policy: A All Consults Inpatient and Outpatient A consult by a physician or nurse is required for Diabetes Educator Services A physicians order is not necessary to initiate a consult B Consults shall be requested utilizing the following guidelines: Guidelines Inpatient General Care All Except: Outpatient Surgery, Observation, Psychiatry See Section B for Consults for these areas Consults shall be entered into Invision on admission to the general care units for patients being admitted with the following Diabetes related diagnosis: a Newly
diagnosed diabetes b Diabetic Ketoacidosis c Hyperglycemic, hyperosmolar coma d Uncontrolled diabetes e Profound hypoglycemia in a known diabetic patient f Pregnancy with diabetes g Initiation of insulin therapy The Diabetes Education Checklist for Insulin Administration SN 7287 shall be placed on the front of the chart when a patient is initially started on insulin therapy The form is to be completed by the nursing staff for patients new to insulin This form should not be used for patients taking insulin prior to admission h Any other patient with a diagnosis of diabetes in whom the physician/nurse identifies a diabetes education deficit i Patients on an insulin pump The following patients will not need to have diabetes education consults See page 5 for more details a Nursing home residents b Blood glucose monitoring for reasons other than Diabetes, ie, hyperalimentation therapy, or steroid induced hyperglycemia c Patients from another health care facility who are sent to LSUHSC for 1 special service who have a private MD or 2 another institution is responsible fo their Diabetes care d Patients being transferred to another facility for rehabilitation especially if the patient is
unresponsive or unconscious Exception: if the patient is going home, and the family members need instruction on how to care for Diabetes Include the following information in the comments section: a Current diabetes medication regimen b Special diabetes education needs

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Diabetes Educator–Page 2 of 5 Guidelines A Inpatient General Care contd All Except: Outpatient Surgery, Observation, Psychiatry See Section B for Consults for these areas 4 The Diabetes Educator will make the appointment for diabetes education with the individual patient 5 The Diabetes Educator will document the diabetes education on the Consultation form and also on the Interdisciplinary Patient Education Form IPEF If there is an urgent need, notify the Diabetes Educator by beeper at 0310 after entering the Consult into Invision

B Inpatient Specialty Outpatient Surgery, Observation, Psychiatry 1 Request consults via Invision on patients identified with the following: a New Onset diabetes b Initiation of insulin therapy c Poor control indicated by HgbA1c 10 or blood glucose consistently 250 mg/ml d Identified education deficit concerning diabetes self care such as lack of understanding of
treatment regimen or disease process 2 Include the following information in the reason for consults: a Current diabetes medication regimen b Special diabetes education needs If there is an urgent need regarding a diabetes education deficit, notify the Diabetes Educator immediately by beeper at 0310 The Diabetes Educator will document the diabetes education on the Consultation form and also on the Interdisciplinary Patient Education Form IPEF

C Family Practice/Comprehensive Care 1 Send consults through Campus Mail addressed to the Diabetes Educator Include the following information on the requested consult: a Current diabetes medication regimen b Special diabetes needs c Address d Phone number 2 During working hours call Ext 55647 or Beeper 1253 and After hours call 55647 or Beeper 1253 the next business day The Diabetes Educator will make the appointments for diabetes education with the individual patient The Diabetes Educator will document the education on the Consultation form and also on the Interdisciplinary Patient Education Form IPEF

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Outpatient Clinics

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Diabetes Educator–Page 3 of 5 1 Send consults through Campus Mail addressed to the Diabetes Educator
Include the following information in the request for consult: a Current diabetes medication regimen b Special diabetes needs c Address d Phone number 2 During working hours call Ext 32542 or Beeper 1808 if there is an urgent need for outpatient diabetes education The Diabetes Educator will make the appointment for diabetes education with the individual patient The Diabetes Educator will document the diabetes education on the Consultation form and also on the Interdisciplinary Patient Education form IPEF

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Responsible Party MD, RN, LPN

Action 1 2 Request Consultation Processing Consults: Inpatient General Care Consults: Notifies Diabetes Educator via Invision Inpatient Specialty: Observation, Outpatient Surgery, and Psychiatry Consults: a b Request consults through Invision If there is an urgent diabetes education need identified, notifies Diabetes Educator of consult at beeper 0310 after the consult is entered into Invision Outpatient Clinic Consults: Sends consults through Campus Mail to the Diabetes Educator

MD, RN, LPN

Diabetes Educator

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Assures that the following information is included on the consult: Current Diabetes medication regimen Special Diabetic needs
Mailing address and telephone Outpatient Clinics Only Contacts patient and schedules teaching within the following time frames: Inpatients: 72 hours after notification of consult Outpatients: New onset insulin 7 days and all other consults 14 days Teaches patient and evaluates patient response Completes consultation form: Inpatients: remains on chart as part of the medical record Outpatients: forwards form to Medical Records for placement in appropriate patient medical record Documents diabetes education on the Consultation form and the Interdisciplinary Patient Education form IPEF Provides Nursing Staff with guidelines for follow-up teaching needs

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Diabetes Educator–Page 4 of 5 DIABETES EDUCATION CONSULTS CRITERIA For In House Patients Patients who need consults done on Admit to the Patients who DO NOT NEED consults done on General Care Area: Admit to the General Care Area: Newly Diagnosed Diabetes Diabetic Ketoacidosis Nursing Home Residents Blood Glucose monitoring for reasons other than Diabetes, ie, hyperalimentation therapy, or steroid induced hyperglycemia Patients from another health care facility who are sent to LSUHSC for: 1 special service who have a
private MD or 2 another institution is responsible for their Diabetes Care Examples: Heart cath, orthopedic surgery, neurosurgery, bone marrow transplant, etc Patients being transferred to another facility for rehabilitation especially if the patient is unresponsive or unconscious Exception: If the patient is going home, and the family members need instruction on how to care for Diabetes

Hyperglycemic, hyperosmolar coma Uncontrolled Diabetes as evidenced by HgbA1C 10 or Blood glucose consistently 250 mg/dl Profound hypoglycemia in a patient with known diabetes Pregnancy with Diabetes

Initiation of Insulin Therapy Any other patient with a diagnosis of Diabetes in whom the physician/ nurse identifies a diabetes education deficit

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Diabetes Educator–Page 5 of 5

Jamie Jett, MBA, RN Director, Patient Care Support/Medicine Services

_______________________________________ Signature

____________________ Date

Pamela B Simmons, PhD, RN Assistant Hospital Administrator and CNO Patient Care Services

_______________________________________ Signature

_____________________ Date

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Source:healthywomen.org