Date of Award

Spring 2021

Project Type

Clinical Doctorate

College or School




Program or Major

Doctor of Nursing Practice

Degree Name


First Advisor

Susan J. Fetzer

Second Advisor

Kim Wolfe

Third Advisor

Anthony McLean


BACKGROUND: Multiple roles contribute to the point of care glucose collection and insulin administration workflow. Diabetes care associations and safety advocates provide recommendations since the time-action profile of prandial insulin requires knowledge and performance to deliver insulin safely.

PROBLEM: Variation of practice in relation to the time that point of care glucose was collected and meal and insulin administration assessments were completed failed to meet parameters.

PURPOSE: A quality improvement project aimed to test the effect audit and feedback has on rapid acting insulin administration and point of care glucose collection practice at meals.

METHOD: Audit and feedback, a knowledge transfer-behavior change intervention, was tested to determine its effectiveness as a technique to translate evidence to practice. Audit and feedback cycles informed nurses of the goals, performance measures, and gaps to improve practice. A pre-test post-test study design was used. Point of care glucose and rapid acting insulin data was retrospectively audited from electronic medical records of a medical-surgical unit.

RESULTS: Post-intervention performance measures indicated the intervention was not effective. Variation persisted after the intervention. While the frequency of outcomes measures did not improve, the quality improvement process revealed information to inform clinical improvements for future quality improvement.

CONCLUSION: Audit and feedback as an intervention for knowledge transfer and behavior change remains a questionable intervention for translating evidence to practice. More evidence is needed of when and how audit and feedback will be most effective must be understood.

Included in

Nursing Commons