Interprofessional collaboration in emergency department nursing care for patients with diabetic ketoacidosis: a narrative review
- 1Emergency Internal Medicine Department, Qinghai University Affiliated Hospital
- 2Emergency Intensive Care Unit (ICU), Qinghai University Affiliated Hospital
Abstract
Introduction: Diabetic ketoacidosis (DKA) is an acute metabolic emergency requiring timely risk recognition, fluid resuscitation, insulin therapy, electrolyte correction, dynamic monitoring, and coordinated care transitions. These interdependent tasks pose substantial challenges to emergency nursing. This narrative review aimed to synthesise current evidence on interprofessional collaboration in emergency DKA nursing and propose a conceptual framework to support coordinated care.
Methods: A structured narrative review was conducted using literature retrieved from PubMed/MEDLINE, Embase, CINAHL, and the Web of Science Core Collection from database inception to July 10, 2026. DKA-specific clinical and implementation evidence was integrated with broader literature on interprofessional collaboration, communication, and healthcare implementation. The evidence was synthesised using Donabedian's structure–process–outcome framework.
Results: Current collaborative approaches include nurse-led standardised pathways, risk-stratified subcutaneous insulin and non-intensive care unit management, collaborative medication management, laboratory and point-of-care monitoring, structured communication, digital decision support, and multidisciplinary discharge planning. Available evidence suggests that standardised collaborative pathways may improve the timeliness and consistency of care, shorten emergency department length of stay, and reduce intensive care resource use. However, evidence evaluating complete interprofessional nursing teams and nursing-sensitive outcomes remains limited. Based on the synthesis, a conceptual closed-loop collaboration framework comprising six interconnected stages was proposed: recognition and activation, shared risk stratification, coordinated monitoring and execution, escalation, care transition, and recurrence prevention.
Discussion: Effective interprofessional DKA nursing requires shared clinical information, explicit responsibility, timely feedback, and predefined escalation procedures, with emergency nurses serving as continuous information integrators and process coordinators. The proposed framework provides an evidence-informed approach to organising collaborative emergency care. However, it has not been prospectively validated, and further implementation research is required to evaluate its feasibility, safety, and effects on nursing-sensitive and patient outcomes.
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BibTeX
@article{gao2026interprofessional,
title = {{Interprofessional collaboration in emergency department nursing care for patients with diabetic ketoacidosis: a narrative review}},
author = {Lili Gao and Chengrong Li and Xue Liu},
journal = {Frontiers in Endocrinology},
year = {2026},
month = oct,
doi = {10.3389/fendo.2026.1963622},
url = {https://www.frontiersin.org/articles/10.3389/fendo.2026.1963622/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Interprofessional collaboration in emergency department nursing care for patients with diabetic ketoacidosis: a narrative review
AU - Lili Gao
AU - Chengrong Li
AU - Xue Liu
PY - 2026
DA - 2026/10/14
JO - Frontiers in Endocrinology
DO - 10.3389/fendo.2026.1963622
UR - https://www.frontiersin.org/articles/10.3389/fendo.2026.1963622/full
AB - Introduction: Diabetic ketoacidosis (DKA) is an acute metabolic emergency requiring timely risk recognition, fluid resuscitation, insulin therapy, electrolyte correction, dynamic monitoring, and coordinated care transitions. These interdependent tasks pose substantial challenges to emergency nursing. This narrative review aimed to synthesise current evidence on interprofessional collaboration in emergency DKA nursing and propose a conceptual framework to support coordinated care. Methods: A structured narrative review was conducted using literature retrieved from PubMed/MEDLINE, Embase, CINAHL, and the Web of Science Core Collection from database inception to July 10, 2026. DKA-specific clinical and implementation evidence was integrated with broader literature on interprofessional collaboration, communication, and healthcare implementation. The evidence was synthesised using Donabedian's structure–process–outcome framework. Results: Current collaborative approaches include nurse-led standardised pathways, risk-stratified subcutaneous insulin and non-intensive care unit management, collaborative medication management, laboratory and point-of-care monitoring, structured communication, digital decision support, and multidisciplinary discharge planning. Available evidence suggests that standardised collaborative pathways may improve the timeliness and consistency of care, shorten emergency department length of stay, and reduce intensive care resource use. However, evidence evaluating complete interprofessional nursing teams and nursing-sensitive outcomes remains limited. Based on the synthesis, a conceptual closed-loop collaboration framework comprising six interconnected stages was proposed: recognition and activation, shared risk stratification, coordinated monitoring and execution, escalation, care transition, and recurrence prevention. Discussion: Effective interprofessional DKA nursing requires shared clinical information, explicit responsibility, timely feedback, and predefined escalation procedures, with emergency nurses serving as continuous information integrators and process coordinators. The proposed framework provides an evidence-informed approach to organising collaborative emergency care. However, it has not been prospectively validated, and further implementation research is required to evaluate its feasibility, safety, and effects on nursing-sensitive and patient outcomes.
SN - 1664-2392
ER -