The nurses on the medical-surgical unit noted a high readmission rate related to hypoglycemia in type 2 diabetes (T2D) patients, including those newly diagnosed and patients who were newly transitioned to insulin management. Given this, the charge nurse met with the nursing team to discuss the discharge protocol for all T2D patients. The nurses discovered there were many T2D patient education materials but no guidelines for selecting the most appropriate materials according to patient needs. The team also discovered that not all of the nurses felt comfortable discharging diabetics. One new nurse shared her experience of discharging a newly diagnosed patient at 5 p.m. on a Friday afternoon. The patient was going home on insulin for the first time but did not have his first endocrinologist appointment until 2 weeks after discharge. The nurse discovered none of the nurses working with the patient before her had initiated diabetic teaching. The patient’s discharge was delayed until the next day.

1.

What CUES (Assessment) can the nurses, using the RE-AIM framework, assess about the lack of a standard approach to teaching patients with diabetes about their disease?

2.

What HYPOTHESIS (Diagnosis) could the nurse form about innovations that could be effective to address the discharge preparation of T2D patients?

3.

What ACTION (Plan and Implement) will be most effective for the nurses to take to ensure safe quality healthcare for patients with type 2 diabetes who have been newly transitioned to insulin or newly diagnosed?

4.

How will the nurses evaluate the OUTCOME (Evaluation) of the team’s work for the purpose of arriving at a satisfactory clinical outcome?