Initiative to Reduce Hospitalization for Pediatric Diabetic Ketoacidosis

Children with diabetic ketoacidosis (DKA) typically exhibit resolution of acidosis within hours of treatment, yet most are hospitalized. Aiming to reduce admission rates for children with established type 1 diabetes, researchers launched an emergency department (ED) −based quality improvement (QI) initiative for those with low-risk DKA (defined as mild acidosis, established disease, awareness of sick-day rules and appropriate home care, and no complex social or comorbid conditions).

The initiative involved development of an evidence-based treatment guideline by a multidisciplinary team and creation of a single standard order set. Nurses received training sessions focused on guideline adherence and administration of insulin and IV fluids. Phy…