Implementation of a Diabetic Resource Toolkit in a Veterans Administration Emergency Department

Diabetes is the 7th leading cause of death in the United States. Uncontrolled diabetes and lack of self-care knowledge leads to increased emergency department (ED) visits, utilizing limited health care resources. The practice-focused question asked whether a patient-focused diabetic self-care toolkit could decrease the number of diabetes-related ED visits. The purpose of this project was to reduce the number of diabetes-related ED visits and was supported by the social cognitive theory. The sources of evidence included the facility\u27s ED Information System (EDIS) data and a patient survey developed by the project lead. There were 149 participants (135 males and 14 females). Before program implementation there were 3240 total ED visits with 124 diabetes-related disposition diagnoses. Post-project there were 3362 total ED visits, with 126 diabetes-related disposition diagnoses. Data collected revealed no meaningful difference between the pre-project and post-project ED diabetes related visits. However, of the 124 pre-project diabetes-related visits, 59 had a triage complaint or disposition diagnosis of medication refill, and of the 126 post-project diabetes-related visits, 33 were medication refills. Although implementation of the diabetes resource toolkit did not help to decrease diabetes related emergency department visits, it did identify that 47.58% of pre-project visits and 26.19% of post-project visits were related to medication refills, showing a 21.39% post-project decrease in medication refill visits. This identifies one potential positive impact of the toolkit implementation. The implications for positive social change from this project is the recognition that medication refills are an impacting contributor to diabetes-related ED visits and from that, nursing practice can gain new knowledge in the fight against diabetes