Format

Send to

Choose Destination
J Hosp Med. 2009 Jul;4(6):331-9. doi: 10.1002/jhm.449.

Impact of improvement efforts on glycemic control and hypoglycemia at a university medical center.

Author information

1
Department of Medicine/Endocrinology, Medical University of South Carolina, Charleston, South Carolina 29425, USA. hermayer@musc.edu

Abstract

BACKGROUND:

Great emphasis is placed on optimizing treatment of hospitalized patients with diabetes and hyperglycemia.

OBJECTIVE:

This study was conducted to determine if the application of hospital-wide insulin order sets improved inpatient safety by reducing the number of actual hypoglycemic and hyperglycemic events and increasing at-target blood glucose.

DESIGN:

A retrospective chart review was conducted of hypoglycemic and hyperglycemic events and at-target blood glucose occurring before and after institution of the insulin order sets and blood glucose protocols.

SETTING:

The Medical University of South Carolina (MUSC) Medical Center is a 709-bed hospital and tertiary referral center for partnering hospitals in the southeastern United States.

PATIENTS:

All patients were evaluated who had a documented history of diabetes or who had at least 1 finger-stick blood glucose above 180 mg/dL who were admitted for care to the MUSC adult main hospital (minimum of 18 years-of-age; maximum 100 years-of-age) during June 2004, June 2005, June 2006, and June 2007.

INTERVENTION:

The intervention involved institution of hospital-wide hypoglycemia, hyperglycemia, subcutaneous insulin, and intravenous insulin treatment protocols.

MEASUREMENTS:

Retrospective data on hypoglycemia, hyperglycemia, and at-target blood glucose incidence and frequency were collected via a computerized repository for all inpatients.

RESULTS:

The percent time in range improved by 10% with no increase in the amount of severe hypoglycemic episodes for the blood glucose results.

CONCLUSIONS:

Implementing standardized insulin order sets including hypoglycemia and hyperglycemia treatment protocols at MUSC produced expected benefits for patient safety for this patient population.

PMID:
19670354
DOI:
10.1002/jhm.449
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Frontline Medical Communications Inc
Loading ...
Support Center