Full Course Description

Module 1: The Basics of Diabetes

  • Strategies to Reduce the Incidence of Hypo & Hyperglycemia in the Acute Patient
  • Critical Interventions for the Patient in Crisis
  • Treating Special Populations: Easy to Use Formulas
  • The Importance of Dosing & Timing
  • Tips & Tools You Can Put into Practice the Next Day

Until recently, glucose control in the hospital setting was largely ignored even in patients with a diagnosis of diabetes. We didn’t realize 1 out of every 3 patients we were caring for was potentially suffering the consequences of uncontrolled hyperglycemia and, worse, these unknown patients were experiencing higher mortality rates after discharge. Bottom line, we MUST do better and you, the bedside nurse, play a critical role in identifying and managing your hypo and hyperglycemic patients.

This seminar will address issues you face in the hospital and give answers to questions you won’t find in any textbook. Imagine being able to look at a single flowsheet and understand exactly why your patient continues to experience hypoglycemia, or persistent hyperglycemia. Expert, Nancy Moline, RN, M.Ed., CDE, will share with you the management techniques and tips she has developed through her extensive experience and increase your understanding of the complexities of diabetes. You will leave this seminar with new tools and formulas to improve the outcomes of your patients with and without diabetes diagnosis.

 

Program Information

Outline

Glycemic Targets for Hospitalized Patients

  • Clear interpretation of AACE & ADA guidelines
  • Adjusting limits for the critically ill patient
  • Non-critical patients: How high is too high

Recognizing Symptoms of Hypoglycemia

  • Hypoglycemic unawareness: How are we missing this?
  • Interventions that change outcomes
  • 15/15 Rule
  • Timing and Dose: The good, the bad, the ugly
    • IV dextrose
    • Glucagon

Reducing Incidence of Hypoglycemia

  • Finger sticks & technique – it does matter!
  • Critical timing for pre-meal & correction insulin
  • The nurse’s role in ensuring carbohydrate-consistent meals

Symptoms & Critical Interventions for Hyperglycemia

  • The differences of DKA & HHNK
  • Diabetic Ketoacidosis
    • A complex metabolic process
    • Identifying the patient at risk
    • Managing fluid replacement to avoid complications
    • Insulin drips
    • Critical labs & acute management
  • Nursing Management of HHNK
    • Identifying the symptoms
    • Don’t forget your ABCs
    • Common laboratory pitfalls
    • Restoring electrolyte balance

Consequences of Acute Hyperglycemia

  • Addressing & managing new wound infections
  • The dangers of:
    • Platelet abnormalities
    • Inflammatory cytokine response
  • The patient & the facility at risk:
    • Poor patient outcomes
    • Readmissions
    • Increased length of stay
  • Insulin resistance

Treating Special Populations Using a Simple Formula

  • The patient newly prescribed steroids
  • Adjusting for tube feedings
  • TPN: Understanding the effects for the diabetic patient
  • Considerations for patients on R-U-500 insulin

Insulin for Improved Glucose Control

  • Type 1 vs. Type 2 guidelines
  • Action times of insulins
  • Calculating Basal/ Bolus Insulin
  • Miami 4/12 Rule
  • Correction scales based on insulin sensitivity

Oral Agents in the Hospital Setting

  • NPO vs eating status
  • Precautions for Metformin

Safety Issues with Managing Insulin Pumps

  • Patient exclusion criteria
  • Recognizing pump problems
  • When to remove pumps

System Improvements Positively Impacting Patient Outcomes

  • Standardized correction scales based on insulin sensitivity
  • Standard protocols for treating hypoglycemia
  • Physician order sets for insulin initiation
  • Carbohydrate labels on meal trays/snacks

Putting It All Together

  • Case Studies: What went right and what went wrong
  • Solving problems using the glucose accordion flowsheet report

 

Objectives

  1. Differentiate glycemic targets for the hospitalized patient
  2. Distinguish symptoms of hypo/hyperglycemia
  3. Assess metabolic consequences of acute hyperglycemia
  4. Utilize a standardized approach to managing glucose in patients on steroids, tube feedings and TPN
  5. Calculate basal/ bolus (prandial) insulin dosing to achieve optimal glucose control
  6. Formulate 2 ways the bedside nurse can reduce the incidence of hypoglycemia in the hospital
  7. Analyze the use of oral agents in the hospital setting
  8. Assess safety issues with using insulin pumps in the acute care setting
  9. Design 2 system improvements that positively impact patient outcomes

Target Audience

Certified Diabetes Educators, Registered Dietitians & Dietetic Technicians, Nurses, Physician Assistants, and other Healthcare Professionals

Copyright : 05/19/2017

Module 2: Diabetes in the Emergency Department

Program Information

Objectives

  1. Differentiate glycemic targets for the hospitalized patient
  2. Distinguish symptoms of hypo/hyperglycemia
  3. Assess metabolic consequences of acute hyperglycemia
  4. Utilize a standardized approach to managing glucose in patients on steroids, tube feedings and TPN
  5. Calculate basal/ bolus (prandial) insulin dosing to achieve optimal glucose control
  6. Formulate 2 ways the bedside nurse can reduce the incidence of hypoglycemia in the hospital
  7. Analyze the use of oral agents in the hospital setting
  8. Assess safety issues with using insulin pumps in the acute care setting
  9. Design 2 system improvements that positively impact patient outcomes

Copyright : 05/19/2017

Module 3: Insulin

Program Information

Objectives

  1. Differentiate glycemic targets for the hospitalized patient
  2. Distinguish symptoms of hypo/hyperglycemia
  3. Assess metabolic consequences of acute hyperglycemia
  4. Utilize a standardized approach to managing glucose in patients on steroids, tube feedings and TPN
  5. Calculate basal/ bolus (prandial) insulin dosing to achieve optimal glucose control
  6. Formulate 2 ways the bedside nurse can reduce the incidence of hypoglycemia in the hospital
  7. Analyze the use of oral agents in the hospital setting
  8. Assess safety issues with using insulin pumps in the acute care setting
  9. Design 2 system improvements that positively impact patient outcomes

Copyright : 05/19/2017

Module 4: Hypoglycemia

Program Information

Objectives

  1. Differentiate glycemic targets for the hospitalized patient
  2. Distinguish symptoms of hypo/hyperglycemia
  3. Assess metabolic consequences of acute hyperglycemia
  4. Utilize a standardized approach to managing glucose in patients on steroids, tube feedings and TPN
  5. Calculate basal/ bolus (prandial) insulin dosing to achieve optimal glucose control
  6. Formulate 2 ways the bedside nurse can reduce the incidence of hypoglycemia in the hospital
  7. Analyze the use of oral agents in the hospital setting
  8. Assess safety issues with using insulin pumps in the acute care setting
  9. Design 2 system improvements that positively impact patient outcomes

Copyright : 05/19/2017

Module 5: Controlling Blood Sugar Levels

Program Information

Objectives

  1. Differentiate glycemic targets for the hospitalized patient
  2. Distinguish symptoms of hypo/hyperglycemia
  3. Assess metabolic consequences of acute hyperglycemia
  4. Utilize a standardized approach to managing glucose in patients on steroids, tube feedings and TPN
  5. Calculate basal/ bolus (prandial) insulin dosing to achieve optimal glucose control
  6. Formulate 2 ways the bedside nurse can reduce the incidence of hypoglycemia in the hospital
  7. Analyze the use of oral agents in the hospital setting
  8. Assess safety issues with using insulin pumps in the acute care setting
  9. Design 2 system improvements that positively impact patient outcomes

Copyright : 05/19/2017

Module 6: Insulin and Insulin Pumps

Program Information

Objectives

  1. Differentiate glycemic targets for the hospitalized patient
  2. Distinguish symptoms of hypo/hyperglycemia
  3. Assess metabolic consequences of acute hyperglycemia
  4. Utilize a standardized approach to managing glucose in patients on steroids, tube feedings and TPN
  5. Calculate basal/ bolus (prandial) insulin dosing to achieve optimal glucose control
  6. Formulate 2 ways the bedside nurse can reduce the incidence of hypoglycemia in the hospital
  7. Analyze the use of oral agents in the hospital setting
  8. Assess safety issues with using insulin pumps in the acute care setting
  9. Design 2 system improvements that positively impact patient outcomes

Copyright : 05/19/2017

Module 7: Barriers to Glycemic Control

Program Information

Objectives

  1. Differentiate glycemic targets for the hospitalized patient
  2. Distinguish symptoms of hypo/hyperglycemia
  3. Assess metabolic consequences of acute hyperglycemia
  4. Utilize a standardized approach to managing glucose in patients on steroids, tube feedings and TPN
  5. Calculate basal/ bolus (prandial) insulin dosing to achieve optimal glucose control
  6. Formulate 2 ways the bedside nurse can reduce the incidence of hypoglycemia in the hospital
  7. Analyze the use of oral agents in the hospital setting
  8. Assess safety issues with using insulin pumps in the acute care setting
  9. Design 2 system improvements that positively impact patient outcomes

Copyright : 05/19/2017

Module 8: Applying What You Learned

Program Information

Objectives

  1. Differentiate glycemic targets for the hospitalized patient
  2. Distinguish symptoms of hypo/hyperglycemia
  3. Assess metabolic consequences of acute hyperglycemia
  4. Utilize a standardized approach to managing glucose in patients on steroids, tube feedings and TPN
  5. Calculate basal/ bolus (prandial) insulin dosing to achieve optimal glucose control
  6. Formulate 2 ways the bedside nurse can reduce the incidence of hypoglycemia in the hospital
  7. Analyze the use of oral agents in the hospital setting
  8. Assess safety issues with using insulin pumps in the acute care setting
  9. Design 2 system improvements that positively impact patient outcomes

Copyright : 05/19/2017

Module 1: Broad Look at Diabetes & Risk Factors

  • New Updates from ADA & AACE
  • Pharmacology Updates
  • Co-Morbidities & Treatment Recommendations
  • Minimizing Biomechanical Complications
  • Managing Acute Complications
  • Special Considerations for Special Populations

DIABETES…Alarming Increases, Devastating Costs, Crippling the Future of America! Every time you watch the news it confirms that you are caring for today’s most common and most complicated patients. The prevention and treatment guidelines seem to change constantly, the patients are getting younger and sicker and you are busier than ever! Are you left wondering how you can make a difference in your patients’ lives?

Expert Mary Ann Rosa works directly with the most challenging patients with diabetes and understands how difficult it is to manage this complex disease. Attend this seminar and increase your understanding of the latest treatment guidelines and pharmacologic interventions. Mary Ann will provide strategies to optimize patient outcomes and practical tips you can use to educate and empower your patients. Don’t miss this opportunity to improve the care you provide to patients with diabetes.

 

Program Information

Outline

New Recommendations

  • American Diabetes Association (ADA)
    • All NEW 2015 Standards of Care
      • BMI Classifications
      • E-cigarettes
  • Immunization Recommendations
  • American Association of Clinical Endocrinologists (AACE)
    • Updates to the Comprehensive
  • Diabetes Algorithm
  • Reimbursement Strategies

Cardiometabolic Disease

  • Dyslipidemia
    • New American College of Cardiology Guidelines
    • Recommended Treatment Based on Risk Factors
  • Critical Lab Values
  • Statin Therapy
  • Non-statin LDL-C-lowering Therapy
  • Fibrates
  • Omega 3
  • Niacin
  • Hypertension
    • Modifications in Diagnostic Criteria
    • Beta-Blockers
    • Calcium Channel Blockers
    • Diuretics
    • Low Dose vs. Aggressive Therapy

Biomechanical Complications

  • New Guidelines for Assessment
  • Foot Exam & Treatment Alterations
  • Skin Assessment
  • Ulcers
    • Strategies for Patient Compliance
    • Recurrence Prevention
  • Neurological Predisposition
    • Peripheral & Autonomic
  • Neuropathies
  • Vascular Considerations
    • Microvascular changes
    • Challenges with Retinopathies

Non-Insulin Medications

  • AACE Profiles & Recommendations
    • Sulfonylureas
    • Meglitinides
    • Thiazolidinediones
    • Biaguanides
    • Alpha-glucosidase Inhibitors
    • DPP-4 Inhibitors
    • SGLT-2 Inhibitors

Blood Glucose Pattern Analysis

  • 2015 Glycemic Targets
  • Adjusting Treatment
  • Utilizing CGM

Individualized Glycemic Treatment Goals

  • Monotherapy
  • Dual Therapy
  • Benefit of Early, Aggressive Control

When to Transition to Insulin

  • Progressive B-cell Failure
  • Insulin Profiles
  • Basal Therapy
  • Intensifying Therapy
  • Benefits of Insulin Pump Therapy
    • New Options
    • Sensor-augmented
    • Closed Loop Therapy

Management Strategies for Acute Complications

  • Diabetic Ketoacidosis (DKA)
  • Hyperglycemic Hyperosmolar Non-ketotic Syndrome (HHNK)
  • Infection
  • Surgery & Hospitalization

Addressing Special Populations

  • Type II in Children/Adolescents
    • Variations in Targets and Therapies
  • Elderly
    • Impact of Co-Morbidities

Putting it All Together

  • AADE-7 Behavioral Goals
  • Strategies for Compliance
  • Motivating Change

 

Objectives

  1. Differentiate the various pharmacologic treatment options for diabetes.
  2. Breakdown effective new strategies to improve patient outcomes.
  3. Formulate a plan of care for the patient with complications related to diabetes.
  4. Integrate motivational interviewing strategies to facilitate patient behavioral changes.
  5. Evaluate biomechanical treatment strategies to improve patient outcomes.
  6. Assess the new recommendations for cardiometabolic disease.
  7. Develop management strategies for the patient experiencing a diabetic emergency.

Target Audience

Certified Diabetes Educators, Registered Dietitians & Dietetic Technicians, Nurses, Pharmacists, Physician Assistants, and other Healthcare Professionals

Copyright : 12/04/2015

Module 2: Screening for Diabetes

Program Information

Objectives

  1. Differentiate the various pharmacologic treatment options for diabetes.
  2. Breakdown effective new strategies to improve patient outcomes.
  3. Formulate a plan of care for the patient with complications related to diabetes.
  4. Integrate motivational interviewing strategies to facilitate patient behavioral changes.
  5. Evaluate biomechanical treatment strategies to improve patient outcomes.
  6. Assess the new recommendations for cardiometabolic disease.
  7. Develop management strategies for the patient experiencing a diabetic emergency.

Copyright : 12/04/2015

Module 3: Self Monitoring & Management Strategies

Program Information

Objectives

  1. Differentiate the various pharmacologic treatment options for diabetes.
  2. Breakdown effective new strategies to improve patient outcomes.
  3. Formulate a plan of care for the patient with complications related to diabetes.
  4. Integrate motivational interviewing strategies to facilitate patient behavioral changes.
  5. Evaluate biomechanical treatment strategies to improve patient outcomes.
  6. Assess the new recommendations for cardiometabolic disease.
  7. Develop management strategies for the patient experiencing a diabetic emergency.

Copyright : 12/04/2015

Module 4: Insulin & Non–insulin Management

Program Information

Objectives

  1. Differentiate the various pharmacologic treatment options for diabetes.
  2. Breakdown effective new strategies to improve patient outcomes.
  3. Formulate a plan of care for the patient with complications related to diabetes.
  4. Integrate motivational interviewing strategies to facilitate patient behavioral changes.
  5. Evaluate biomechanical treatment strategies to improve patient outcomes.
  6. Assess the new recommendations for cardiometabolic disease.
  7. Develop management strategies for the patient experiencing a diabetic emergency.

Copyright : 12/04/2015

Module 5: Comorbidities

Program Information

Objectives

  1. Differentiate the various pharmacologic treatment options for diabetes.
  2. Breakdown effective new strategies to improve patient outcomes.
  3. Formulate a plan of care for the patient with complications related to diabetes.
  4. Integrate motivational interviewing strategies to facilitate patient behavioral changes.
  5. Evaluate biomechanical treatment strategies to improve patient outcomes.
  6. Assess the new recommendations for cardiometabolic disease.
  7. Develop management strategies for the patient experiencing a diabetic emergency.

Copyright : 12/04/2015

Module 6: Nutrition Therapy & Physical Activity

Program Information

Objectives

  1. Differentiate the various pharmacologic treatment options for diabetes.
  2. Breakdown effective new strategies to improve patient outcomes.
  3. Formulate a plan of care for the patient with complications related to diabetes.
  4. Integrate motivational interviewing strategies to facilitate patient behavioral changes.
  5. Evaluate biomechanical treatment strategies to improve patient outcomes.
  6. Assess the new recommendations for cardiometabolic disease.
  7. Develop management strategies for the patient experiencing a diabetic emergency.

Copyright : 12/04/2015

Module 7: Strategies for Patient Adherence

Program Information

Objectives

  1. Differentiate the various pharmacologic treatment options for diabetes.
  2. Breakdown effective new strategies to improve patient outcomes.
  3. Formulate a plan of care for the patient with complications related to diabetes.
  4. Integrate motivational interviewing strategies to facilitate patient behavioral changes.
  5. Evaluate biomechanical treatment strategies to improve patient outcomes.
  6. Assess the new recommendations for cardiometabolic disease.
  7. Develop management strategies for the patient experiencing a diabetic emergency.

Copyright : 12/04/2015

Module 8: Telehealth

Program Information

Objectives

  1. Differentiate the various pharmacologic treatment options for diabetes.
  2. Breakdown effective new strategies to improve patient outcomes.
  3. Formulate a plan of care for the patient with complications related to diabetes.
  4. Integrate motivational interviewing strategies to facilitate patient behavioral changes.
  5. Evaluate biomechanical treatment strategies to improve patient outcomes.
  6. Assess the new recommendations for cardiometabolic disease.
  7. Develop management strategies for the patient experiencing a diabetic emergency.

Copyright : 12/04/2015

Module 9: Self–management Education and Case Studies

Program Information

Objectives

  1. Differentiate the various pharmacologic treatment options for diabetes.
  2. Breakdown effective new strategies to improve patient outcomes.
  3. Formulate a plan of care for the patient with complications related to diabetes.
  4. Integrate motivational interviewing strategies to facilitate patient behavioral changes.
  5. Evaluate biomechanical treatment strategies to improve patient outcomes.
  6. Assess the new recommendations for cardiometabolic disease.
  7. Develop management strategies for the patient experiencing a diabetic emergency.

Copyright : 12/04/2015