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

Objective: The objective of this project was to address the inconsistent understanding and utilization of the Diabetic Ketoacidosis (DKA) protocol in a high-acuity emergency department within a large hospital system, where baseline survey results showed that 84% of nurses found the DKA order set confusing and only 15% felt “very comfortable” applying it.

Aim: The aim was to improve nurse clarity, confidence, and consistency in using the DKA protocol to support timely, evidence-based management of this high-risk, time-sensitive condition.

Methods: The intervention consisted of brief, targeted education delivered during pre-shift huddles across day and night shifts, focusing on the correct use of the DKA order set, role clarification, insulin and electrolyte management, hourly glucose monitoring requirements, equipment access, and admission workflow. A pre- and post-shift survey measured changes in protocol familiarity, perceived barriers, and self-reported comfort.

Results: Results demonstrated increased staff familiarity with key components of the protocol, decreased reported confusion with the order set, and improved confidence applying the DKA workflow, including a clearer understanding of insulin ordering, glucose monitoring expectations, and the correct sequence of management steps.

Conclusions: These findings suggest that a brief, structured educational intervention can strengthen protocol adherence and support safer, more consistent DKA management in the emergency department.

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