Date of Conferral
11-14-2025
Date of Award
November 2025
Degree
Doctor of Nursing Practice (DNP)
School
Nursing
Advisor
Dr. Camilla Jaekel
Abstract
This Doctor of Nursing Practice (DNP) project addressed a critical gap in care at a 24-bed, combined, intensive care unit (ICU): The absence of a standardized, evidence-based clinical practice guideline (CPG) for managing diabetic ketoacidosis (DKA). DKA is a life-threatening emergency requiring timely, coordinated, and evidence-driven management. Despite its prevalence, the project site ICU lacked formal guidelines, resulting in fragmented care delivery and inconsistent treatment practices. Project site leadership expressed concerns that the absence of a unified protocol contributed to increased workload for nurses and physicians with frequent interruptions for order verification and delays that compromised patient safety and care efficiency. The project was guided by the following question: Can an evidenced-based CPG for adult patients with DKA in the ICU receive agreement by content experts of at least 80% in the six domains of the Appraisal of Guidelines for Research & Evaluation II (AGREE II) tool? In the project, I followed the Walden University DNP Clinical Practice Guideline Development Checklist . The initiative involved collaboration with key stakeholders, multiple rounds of expert clinical review, and rigorous appraisal using the AGREE II Tool to ensure methodological quality and transparency. The DKA CPG achieved an overall quality score of 96.2, demonstrating intense methodological rigor, clarity, and applicability. Implementing this guideline will standardize ICU practice, reduce workflow interruptions, enhance the timeliness of care, and improve outcomes for critically ill patients with DKA. This CPG acts as a means for equity by transforming clinical standardization to address structural disparities.
Recommended Citation
Leftwich, Kushom Gurung, "Development of a Clinical Practice Guideline for Diabetic Ketoacidosis (DKA) Management in the Intensive Care Unit" (2025). Walden Dissertations and Doctoral Studies. 18766.
https://scholarworks.waldenu.edu/dissertations/18766
