Journal
JOURNAL OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION
Volume 14, Issue 3, Pages 278-287Publisher
OXFORD UNIV PRESS
DOI: 10.1197/jamia.M2292
Keywords
-
Categories
Funding
- AHRQ HHS [HS 1-0384] Funding Source: Medline
- NIDDK NIH HHS [U01 DK30620] Funding Source: Medline
- NLM NIH HHS [1 R01 LM007995, T15 LM007450, T15 LM07450, R01 LM007995] Funding Source: Medline
Ask authors/readers for more resources
Objective: Hyperglycemia worsens clinical outcomes in critically ill patients. Precise glycemia control using intravenous insulin improves outcomes. To determine if we could improve glycemia control over a previous paper-based, manual protocol, authors implemented, in a surgical intensive care unit (SICU), an intravenous insulin protocol integrated into a care provider order entry (CPOE) system. Design: Retrospective before-after study of consecutive adult patients admitted to a SICU during pre (manual protocol, 32 days) and post (computer-based protocol, 49 days) periods. Measurements: Percentage of glucose readings in ideal range of 70-109 mg/dl, and minutes spent in ideal range of control during the first 5 days of SICU stay. Results: The computer-based protocol reduced time from first glucose measurement to initiation of insulin protocol, improved the percentage of all SICU glucose readings in the ideal range, and improved control in patients on IV insulin for >= 24 hours. Hypoglycemia (< 40 mg/dl) was rare in both groups. Conclusion: The CPOE-based intravenous insulin protocol improved glycemia control in SICU patients compared to a previous manual protocol, and reduced time to insulin therapy initiation. Integrating a computer-based insulin protocol into a CPOE system achieved efficient, safe, and effective glycemia control in SICU patients.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available