Insulin and Discontinued Diet Orders

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Mon, 07/12/2021 - 20:38

James Gibson

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Last seen: 1 week 3 days ago

Joined: 09/27/2019 - 11:57

Insulin and Discontinued Diet Orders

We have ongoing issues with hypoglycemia that arises after a patient receives regular/basal insulin to cover tube feeds and then the tube feed regimen is discontinued or NG tube is clogged/pulled. Nursing staff is finding it hard to remember to monitor POC glucose more closely when dextrose source is removed.

We have tried to address through RN staff education and have defaulted guidance into the insulin orders, but the issue persists.

Tube feed orders are not captured on the MAR at our institution and so pharmacists are not aware when enteral support is removed and so would not be able to intervene.

Has anyone devised decision support around this? We are an Epic-based EMR if helpful.

Thank you,
James Gibson
UW Medicine

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