Super-users to the Rescue

By Lester Davis
Nurse specialists help get diabetes under control

With more than 2,000 nurses and nearly 1,000 beds, the task of improving care for diabetic inpatients at The Johns Hopkins Hospital could seem downright daunting. But with a cadre of Super-users–nurse experts in diabetes management and patient care–on each unit, the situation (and blood sugar levels) are under control.

“The disease can negatively affect a patient’s recovery,” noted nurse practitioner Joanne Dintzis, MSN, CRNP, CDE. “If hospitals don’t improve blood sugar levels of inpatients, they can suffer from wound infections and slower healing after surgery.” And insulin, which is often used to treat the disease, is considered a top-five high-risk drug that, if delivered incorrectly, can lead to death.

Dintzis serves as a clinical facilitator, charged by a taskforce of hospital leaders to improve diabetes care.

In 2006, improving care for diabetic inpatients gained steam after the American Diabetes Association and the American Association of Clinical Endocrinologists released a joint statement calling for improved care of diabetic patients in American hospitals.

That year, the Hopkins taskforce developed a series of workshops to educate nurses about the dangers facing diabetic inpatients whose blood sugar is insufficiently monitored. But the workshops were reaching a tiny fraction of the nurses. “It was a good turnout,” said Dintzis, “but we still had an awful lot of nurses we were not reaching.”

That’s when the taskforce conceived the idea of Super-users.

Each of the hospital’s more than 40 care units has now committed at least one nurse to help educate other nurses about properly managing diabetes. Currently Hopkins has 90 Super-users, and the program is widely successful.

“We help the Super-users understand the hospital policies associated with diabetes care, and then they can be our liaisons with the staff on their units,” Dintzis said. “We’re really focused on keeping the patient safe and avoiding harm because it is a dangerous disease.”