Diabetes Mellitus

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Trace DC73-13

DiraChart Clinical Reference
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1. Purpose and clinical relevance

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Daily-note bank — routine skilled days

Scenario

Model daily note (edit to the shift)

Insulin management, stable

Fasting 128, pre-dinner 146 within range on a basal-bolus regimen with correction per scale, no symptoms, intake consistent, feet intact with protective care. Skilled interpretation and administration required daily; supports the Section N insulin day.

New insulin titration

Fasting trend 210 → 156 over three days on the titrating basal dose, no hypoglycemia, self-administration teaching with return-demo progressing. Skilled titration, monitoring, and teaching required; supports Section N.

Discharge self-management teaching

Insulin-pen return-demo 9/9 and 15-15 teach-back 100% with the resident and daughter; sick-day and foot-care reviewed. Covered skilled teaching to competence; supports Section N.

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