Date of Graduation

Fall 12-12-2025

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)

College/School

School of Nursing and Health Professions

Program

MSN project

First Advisor

Jennifer Zesati, MSN, RN

Abstract

Problem There was inconsistency in implementation of the DKA protocol by nurses in the emergency department at the Hospital A. Only 58% of the nurses reported feeling comfortable following the DK protocol, and 84% of the nurses described the DKA order set as confusing. Context Hospital A is a large magnet-recognition hospital system in the Bay Area. The emergency department at Hospital A averages about 12 DKA patients per quarter. Intervention Education sessions were held during pre-shift cuddles across day and night shifts to clarify the DKA protocol and answer any questions or nurses may have. Measures Baseline surveys and post-education surveys were collected in order to measure the changes in the nurses’ knowledge related to the DKA protocol. Results The findings showed an increase in the percentage of nurses that reported feeling “very comfortable” with the DKA protocol from 15% to 55% after education sessions. The nurses that reported the DKA order set was too confusing as a barrier to implementation of the protocol decreased from 84% to 51%, and the percentage of nurses that indicated having “excellent” knowledge of the DKA protocol increased from 10% on the baseline surveys to 40% on the post-education survey. Conclusion The results from this project indicate that education sessions are useful in improving protocol knowledge and comfort among nurses. However, in order to sustain these results and create lasting improvement in practice, education sessions should be standardized and included in new hire orientation, and chart audits should be done to assess for change.

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