Implementation of a Standardized Preoperative Diabetes Medication Guideline and its Effect on Day of Procedure Blood Glucose Levels.

PURPOSE: The purpose of this project was to determine the effect of implementation of a preoperative diabetes medication management guideline on day of procedure blood glucose (BG) levels.

DESIGN: This project was designed as pre- and postimplementation process improvement project based on the Iowa Model of evidence-based practice.

METHODS: Anesthesia providers were surveyed for knowledge and confidence before and following education. Surgical patients with diabetes were provided instructions for all classes of prescribed diabetes medications. Day of procedure BG levels were compared prior to and following the guideline implementation.

FINDINGS: Provider knowledge scores increased 4.5 points (95% confidence interval [CI] 3.2, 5.8) and confidence improved 31.3 percentage points (95% CI 20.8, 41.7). Mean BG level was 132.3 (SD 37.5) before implementation and 130.4 (SD 44.7) after implementation.

CONCLUSIONS: The project resulted in significant gains in provider knowledge and confidence, but no significant difference in preoperative BG levels following implementation of the guideline.