Date of Completion
Summer 2026
Document Type
DNP Scholarly Project
Academic Department
School of Nursing
Degree Type
Doctoral
Degree Name
Doctor of Nursing Practice
First Advisor
Melanie Brewer, DNSc, RN, FNP-BC, NEA-BC, FAANP
Second Advisor
Adriane Stasurak, DNP, RN, ANP-BC
Abstract
Problem: Timely insulin administration is essential for safe inpatient diabetes management and is strongly associated with improved glycemic control and fewer adverse events. Despite ADA recommendations to administer insulin within 30 minutes of point‑of‑care (POC) glucose testing, internal data showed only 44% compliance, with an average delay of 44 minutes. These delays increased the risk of hypo‑ and hyperglycemia and highlighted the need for workflow redesign and strengthened nursing processes.
Aim of the Project: To increase the percentage of insulin doses administered within 30 minutes of POC glucose testing, reduce adverse glycemic events, enhance patient safety, and align practice with ADA/ISMP standards.
Review of the Evidence: Research consistently demonstrates that administering insulin within 30 minutes of POC glucose testing improves glycemic stability, reduces complications, and may shorten hospital length of stay. Delays contribute to dysglycemia and higher healthcare costs. Effective strategies include structured workflows, targeted staff education, interdisciplinary communication, and real‑time performance feedback.
Project Design: A Quality Improvement (QI) framework using the Plan‑Do‑Study‑Act (PDSA) cycle guided project development and evaluation.
Intervention: Over 12 weeks, staff received education on ADA/ISMP guidelines and a redesigned workflow in which the RN obtained the POC glucose and immediately administered insulin. Insulin timing and glucose values were continuously monitored to assess adherence and impact.
Significant Findings/Outcomes: Timeliness of insulin administration improved with compliance increasing from 44% at baseline to 73.3% post‑intervention, demonstrating progress toward the 90% goal. Balancing measures showed no increase in insulin administration errors, indicating that workflow acceleration did not compromise medication safety. Glycemic outcomes shifted following implementation: hypoglycemia events increased from 0% to 8.8%, while hyperglycemia episodes decreased from 65% to 43%, supporting the relationship between timely insulin administration and improved glycemic control (ADA, 2025). The findings align with existing literature that insulin administered promptly after glucose testing reduces glycemic variability and enhances overall inpatient diabetes outcomes.
Implications for Nursing: The new workflow strengthened RN accountability, reduced communication delays, and streamlined the connection between glucose assessment and insulin administration. Sustaining improvements will require ongoing education, integration into orientation and annual competencies, and continued leadership engagement through rounding and performance feedback.
Recommended Citation
Lenox, Katlyn, "Timing Matters: Safe and Timely Insulin Administration" (2026). Doctor of Nursing Practice (DNP) Scholarly Project. 63.
https://fuse.franklin.edu/dnp-project/63
Rights
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