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Improving insulin ordering safely: The development of an inpatient glycemic control program
Author(s) -
Thompson Rachel,
Schreuder Astrid B.,
Wisse Brent,
Jarman Kenny,
Givan Kathleen,
Suhr Louise,
Corl Dawn,
Pierce Becky,
Knopp Robert,
Goss J. Richard
Publication year - 2009
Publication title -
journal of hospital medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.128
H-Index - 65
eISSN - 1553-5606
pISSN - 1553-5592
DOI - 10.1002/jhm.494
Subject(s) - medicine , glycemic , hypoglycemia , psychological intervention , hospital medicine , intensive care medicine , emergency medicine , insulin , pediatrics , nursing
This report describes a Glycemic Control Program instituted at an academic regional level‐one trauma center. Key interventions included: 1) development of a subcutaneous insulin physician order set, 2) use of a real‐time data report to identify patients with out‐of‐range glucoses, and 3) implementation of a clinical intervention team. Over four years 18,087 patients admitted to non‐critical care wards met our criteria as dysglycemic patients. In this population, glycemic control interventions were associated with increased basal and decreased sliding scale insulin ordering. No decrease was observed in the percent of patients experiencing hperglycemia. Hypoglycemia did decline after the interventions (4.3% to 3.6%; p = 0.003). Distinguishing characteristics of this Glycemic Control Program include the use of real‐time data to identify patients with out‐of‐range glucoses and the employment of a single clinician to cover all non‐critical care floors. Journal of Hospital Medicine 2009;4:E30–E35. © 2009 Society of Hospital Medicine.