A PROCESS IMPROVEMENT TOOL TO ENHANCE AND MONITOR THE TREATMENT OF CHILDREN AND ADOLESCENTS WITH DIABETIC KETOACIDOSIS (DKA)

Diabetic ketoacidosis remains a significant cause of morbidity and mortality in children with diabetes mellitus with complications ranging from severe dehydration, electrolyte imbalance, hypercoagulability, pulmonary aspiration, and cerebral edema. Hourly monitoring of laboratory values, especially glucose and sodium [Na+], and fluid status of patients is utilized in many treatments. These values are generally recorded on static sheets next to the patient’s bedside or in an electronic medical record. Such static measures provide limited tools to evaluate trends in treatment and deviations from standard treatment protocols, therefore a process improvement tool was developed to enhance and monitor the treatment of children with DKA. A retrospective chart analysis from fifteen (15) children who were previously admitted to the pediatric intensive care unit (PICU) for treatment of DKA at Cook Children’s Medical Center was conducted. The data previously obtained during the child’s inpatient hospital course was used to assess the functionality of a newly developed computer monitoring tool. Purpose (a): The purpose of this research is to conduct a proof of concept study to determine the ability of a novel process improvement tool to enhance the treatment of children < 18 years of age with diabetic ketoacidosis (DKA). Methods (b): A process improvement tool was developed using an Excel platform. A retrospective study of fifteen patients admitted to the pediatric intensive care unit (PICU) at Cook Children's Medical Center for the treatment of DKA was used to evaluate the functionality of the process improvement tool. Results (c):The process improvement tool enables visual assessment of treatment trends and outcomes along with immediate feedback on the treatment course upon discharge from the PICU. Conclusions (d): A process improvement tool with visual monitoring and tracking of treatment trends is desirable in the treatment if DKA.