American Journal of Nursing Research. 2019, 7(4), 664-669
DOI: 10.12691/AJNR-7-4-28
Original Research

Barriers and Strategies of Implementing DKA Care Set in the Emergency Department within the Banner System as Perceived by Nurses

Hala Ibrahim Zaiton1, , Joyce Toriente Relloso2 and Edgar Gatioan Manood3

1Medical-Surgical Nursing Department, Faculty of Nursing, Zagazig University, Elsharkia Governorate Egypt

2Nursing Management, College of Nursing, Taibah University, Medina, Kingdom of Saudi Arabia

3Development Education, College of Nursing, Taibah University, Medina, Kingdom of Saudi Arabia

Pub. Date: June 24, 2019

Cite this paper

Hala Ibrahim Zaiton, Joyce Toriente Relloso and Edgar Gatioan Manood. Barriers and Strategies of Implementing DKA Care Set in the Emergency Department within the Banner System as Perceived by Nurses. American Journal of Nursing Research. 2019; 7(4):664-669. doi: 10.12691/AJNR-7-4-28


There are different barriers and strategies for implementing diabetic ketoacidosis (DKA) care set in the emergency department (ED). However, there is limited research on DKA care set in the ED. The current research tries to determine the barriers and strategies of implementing diabetic ketoacidosis (DKA) care set within the Banner system as perceived by nurses in the ED. The study utilized a qualitative descriptive method using a semi-structured face-to-face interview. Twelve (12) nurses from the Emergency Room(ER) aged 24 to 48 were the participants of the study. The qualitative inductive content analysis revealed four (4) main categories and themes regarding participant’s perceptions about barriers of implementing the DK care set in E; these are; Knowledge, Experience and Competence in identifying cases of DKA, Communication, and Language. Findings demonstrate that it is essential that nurses should profound understanding of DKA to assess and distinguish its symptoms from other diseases. Hence, knowledge of DKA pathophysiology and competence to identify its symptoms is significant in delivering the appropriate management and care. The study posits that the identified barriers (knowledge, experience, and competence in identifying cases of DKA, communication, and language) significantly affect the success of implementing the DKA Care Set. A collaborative effort is significant in the care of DKA patient; therefore, there is a need for a nursing staff education and training to enhance protocol adherence of protocol throughout DKA.


diabetic ketoacidosis, treatment of hyperglycemia in ER, DKA management, DKA guidelines, DKA management algorithm


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