For Physicians

DNC Inpatient Services:

• Diabetes Clinical Nurse Specialist provides quality assurance, blood glucose data collection, policy & procedure review, SCIP measure monitoring, and education for staff and patients
• Certified Diabetes Educators (CDE) provide basic education and glycemic control assistance for SJH and SJE
• To order inpatient services, 1 to 2 days prior to discharge, write something like: "Consult Diabetes Center for teaching" OR "Consult Diabetes Center for glycemic control assessment" OR "Consult Diabetes Center for insulin administration teaching"
• BG TARGET is less than 180mg/dL overall - use of sliding scale (correction) insulin alone is NOT recommended; nurses will contact physician if BG's remain >180mg/dL
• Quality data is collected monthly and reported to quality committees, hospitalists, nursing management as well as physicians.
• Evidenced based practice is followed as recommended by the ADA (American Diabetes Association) and the AACE (American Association of Clinical Endocrinologists
• Inpatient standing orders include:
  • Blood Glucose Control protocol (this just allows for fingerstick blood glucose's(FSBG), A1c, other lab work as needed)
  • Basal Bolus Insulin Initiation Protocol
  • Non-Critical Care IV insulin infusion Protocol
  • Critical Care IV insulin infusion Protocol
  • Hypoglycemia - Severe Protocol
  • DKA/HHS Protocol
  • Insulin Pump Protocol (for use in the hospital)
  • Perioperative Blood Glucose Control Protocol for insulin and non insulin diabetes patients (this is only used thru the outpatient surgery unit)

DNC Outpatient Services: (good for follow up needs after discharge from the hospital)

• Certified Diabetes Educators (RD and RN) provide a series of 3 classes after an initial assessment session
• Documentation regarding patient attendance is faxed back to the patient's primary physician
• To order outpatient services, complete the referral form and fax to 859.313.4390 (central scheduling); if questions please call 859.313.2393
• Individual sessions and group classes include:
  • Diabetes Basics
  • Consistent Carbohydrate meal planning
  • Blood glucose monitoring
  • Insulin administration
  • Other specific diet instructions as Celiac Disease, etc
  • Gestational Diabetes
• Most insurance companies, Medicare, and Medicaid provide coverage for diabetes education. Since coverage varies, patients are encouraged to check their insurance company for benefits.
• See outpatient referral forms for specific education need: Diabetes Education Referral Form,
  Gestational Referral Form, Nutrition Education Referral Form.