Steroid-Induced Hyperglycemia in Patients with Malignancies: Healthcare Team Adaptation to a Paradigm Shift

摘要

Background: Caring for patients with malignancies and presenting hyperglycemia has been an ongoing problem that needed to be addressed. The Endocrinologist Society and the Joint British Diabetes Societies for Inpatient Care suggested a change in the process by which patients in this population are managed.;Purpose: The purpose of this project was to implement evidence-based practice guidelines for managing steroid-induced hyperglycemia focusing on the interdisciplinary team and adaptation of nurses who care for patients with malignancies.;Theoretical Framework: The theoretical framework selected for this project was Roy's Adaptation Model.;Methods: This project used a mixed method approach, with a triangulation design and incorporation of focus groups and a survey to evaluate the multidisciplinary team adaptation.;Results: The results indicated that 93% of the team reported positive perceptions of adaptation to the change in blood glucose monitoring with this patient population. Dietary staff expressed some concern with their change in procedures to support the steroid-induced hyperglycemia protocol.;Conclusion: This project demonstrated that the healthcare team can adapt to changes, that changes are difficult but needed to improve patients' outcomes. The pursuit of evidence-based practice involves ongoing appraisal of current standards of care with patient outcomes for consideration of the need for change or a paradigm shift.