1. Hypoglycemia Flow Sheet Created by: Diabetes Care Center Joyce Jones, RN, BSN, CDE Patty Lord, RN, BSN, CDE 12/10/12

2. New Documentation A Hypoglycemic Flow Sheet has been created in Soarian. Anytime a patient has a POC blood glucose test or lab test less than 70 mg/dl, the flow sheet will be sent to the Nurse work list.

3. Hypoglycemia Stat finger stick POC blood glucose when Hypoglycemia is suspected: POC blood glucose is less than 70 mg/dl with or without symptoms POC blood glucose is less than 70 mg/dl, should notify nurse and the glucometer must be immediately docked.

4. 1.The Hypoglycemic Event is the time in which you were notified or became aware that the patient had a low blood glucose 2.Your Initial Nurse Interventions are your first line treatments given to the patient according to Lake Health Hypoglycemia guidelines 3.Possible reasons for the Hypoglycemic event are documented 4.Document education given 5.Patient not applicable and Note are available for documentation. 6.Sign as complete 1 st Hypoglycemic Event FS is pushed to your nurse worklist

5. 1.Continued low blood glucose results will push additional flowsheets to your worklist 2.Document the Retesting/Nurse Interventions 3.Document Possible reasons and Education 4.Save as Complete. Additional Hypoglycemic Flowsheets

6. Possible Reasons for Hypoglycemic Event With every initial or each low blood glucose, possible reasons for hypoglycemic event are documented.

7. Retesting/Nurse Interventions after the Initial Intervention

8. New“Orange” Veriphy Alert Veriphy System will now have an ORANGE ALERT. The orange alert will be for blood glucoses that range from greater than 40 mg/dl to 69 mg/dl. The orange alert will come from any BMP, CMP, Glucose, Renal panel or fasting blood sugar. It will NOT alert for POC glucoses. That communication MUST happen between the PCA and the nurse. These alerts must be closed out of Veriphy just as the red critical results.

9. Hypoglycemia Reference Sheet The Lake Health Hypoglycemia Intervention Reference Sheet (dated 11/12) is attached to the bottom of the Hypoglycemic Event FS. Both the Flowsheet and the Reference Sheet are located on the Intranet under Diabetic Downtime Documentation if needed.

10. Patient Record The Hypoglycemic Event FS may be seen under all Assessments and in the Diabetes Documentation on the Clinical Summary.