Publication Date


Degree Awarded Date

December 15, 2023



Background and Review of Literature: Patients with diabetes (PWD) are at higher risk of requiring surgery and developing complications in the perioperative period making euglycemia an important component of intraoperative care. There is an association between dysglycemias and adverse perioperative outcomes. Implementation science evidence indicates that education with audit feedback strategies towards barrier identification to clinical practice guideline (CPG) uptake will improve implementation success.

Purpose: The purpose of this quality improvement project was to evaluate and improve adherence to intraoperative glucose monitoring outlined by the current intraoperative glucose management guideline at a midwestern academic hospital through barrier identification with tailored educational programs and audit feedback strategies.

Methods: Baseline patient data via a retrospective chart review were collected, organized, and analyzed along with, provider attitudes and barriers towards the blood glucose guideline via a provider Likert-type survey.

Implementation Plan/Procedure: An education component tailored to the identified barriers was presented in a PDF PowerPoint and distributed via email and in-service roving education to anesthesia providers in the operating room caring for PWD.

Implications/Conclusion: The purpose, aim, and objectives of the DNP project were met in regard to implementing an educational initiative to all anesthesia providers. An improvement was seen at the four-week interval during the roving in-service education. It is expected for adherence rates to continue to improve as additional system electronic health record changes are implemented in the upcoming months. In addition, the goals of identifying the top three barriers to the intraoperative guideline and providing a baseline adherence rate were achieved.


English (en)

Document Type



Spencer, Julie DNP, RN, CDCES (Chair) Barnes Jewish College, Goldfarb School of Nursing

Associated Committee

Torres, Brian DNP, CRNA (Co-Chair) Barnes Jewish College, Goldfarb School of Nursing

Wolfe, Rachel PharmD, MHA, BCCCP (Member) Washington University School of Medicine in St. Louis

Included in

Nursing Commons