We conclude that the IVIIC is a safe nurse-driven protocol with excellent BG outcomes.

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. Journal of Hospital Medicine 2009;4:331–339. © 2009 Society of Hospital Medicine.

Abbreviations: (ADA) American Diabetes Association, (BG) blood glucose, (CDE) certified diabetes educator, (CTICU) cardiothoracic intensive care unit, (D50W) 50% dextrose in water, (DKA) diabetic ketoacidosis, (HDTF) hospital diabetes task force, (HHNK) hyperglycemic hyperosmolar nonketotic coma, (HTML) hypertext markup language, (ICU) intensive care unit, (IV) intravenous, (IVI) intravenous insulin, (IVIIC) intravenous insulin infusion calculator, (IVP) intravenous push, (MAR) medication administration record,

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