Computerisation of a paper-based intravenous insulin protocol reduces errors in a prospective crossover simulated tight glycaemic control study

Lee, Anthony; Faddoul, Badia; Sowan, Azizeh K.; Johnson, Karen; Silver, Kristi; Vaidya, Vinay

doi:10.1016/j.iccn.2010.03.001

Cited by 21 publications

(50 citation statements)

References 26 publications

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“…The cost simulations of our hospital's five-bed ICU suggested that this may allow cost cuts of US $14,000 per year in personnel expenses related to nurses. The high number of incidents has also been quoted as the second issue in the management of blood glucose using the sliding-scale method [13]. Nurses dealing with the care of critically ill patients in the ICU are constantly under tension and stress [14].…”

Section: Discussionmentioning

confidence: 99%

Blood glucose control using an artificial pancreas reduces the workload of ICU nurses

Mibu

Yatabe

Hanazaki³

2011

J Artif Organs

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Blood glucose management is one of the important therapies in the intensive care unit (ICU). However, blood glucose management using the sliding-scale method increases the workload of ICU nurses. An artificial pancreas, STG-22, has been developed to continuously monitor blood glucose levels and to maintain them at appropriate levels. In this study, we examined the hypothesis that compared to conventional methods, blood glucose management using the STG-22 reduces the workload of ICU nurses and has a positive impact on awareness regarding the management of blood glucose. This study included 45 patients who underwent elective surgery and were treated at the ICU postoperatively. The patients were separated into the following two groups: (1) blood glucose was maintained using the STG-22 (AP group) and (2) blood glucose was maintained using the sliding-scale method (SS group). In addition, a questionnaire was developed for an awareness survey of ICU nurses (N = 20). The frequency of blood sampling and number of double checks were significantly lower in the AP group (1.3 ± 1.4 vs. 8.9 ± 8.1 times/admission, P < 0.001; 1.0 ± 1.4 vs. 9.8 ± 8.5 times/admission, P < 0.001). The time needed for glucose management per admission was significantly shorter in the AP group (9 ± 13 vs. 27 ± 24 min/admission; P = 0.003). Use of STG-22 for glucose management in the ICU increased the degree of attention given by nurses to glucose management and contributed to an improved sense of security. In conclusion, using the STG-22 in the ICU reduces the workload of ICU nurses compared to using the sliding-scale method. It also contributed to the reduction of the ICU nurses' anxiety related to the management of blood glucose.

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Section: Discussionmentioning

confidence: 99%

Blood glucose control using an artificial pancreas reduces the workload of ICU nurses

Mibu

Yatabe

Hanazaki³

2011

J Artif Organs

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“…Computerized insulin infusion protocols such as Glucommander (Glytec, Greenville, SC) have been demonstrated to improve glycemic control, decrease the risk of calculation errors, and can provide reminders for BG checks. [15][16][17][18][19][20][21][22][23] A recent study demonstrated a 98.2% adherence rate to the insulin dose prescribed when using the Space GlucoseControl system (B. Braun, Melsungen, Germany). 23 However, errors can still occur in sampling interval, data entry, and pump programming.…”

Section: Nurse-managed Insulin Infusion Protocolmentioning

confidence: 99%

Evaluation of a Nurse-Managed Insulin Infusion Protocol

Passarelli

Gibbs

Rowden

et al. 2016

Diabetes Technology & Therapeutics

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“…Improvements in the quality of care and patient outcomes were the focuses of 3 papers (Andreessen, Wilde, & Herendeen, 2012;De Laat, Schoonhoven, Pickkers, Verbeek, & Van Achterberg, 2006;Sinuff, Cook, Randall, & Allen, 2003), and both changes in clinical practices and patient outcomes after the implementation of CCGs were the focuses of 6 papers (Abbott, Dremsa, Stewart, Mark, & Swift, 2006;Habich et al, 2012;Higuchi, Davies, Edwards, Ploeg, & Virani, 2011;Hoekstra et al, 2010;McMullin et al, 2006;Webb, Flagg, & Fink, 2006). Twelve of the studies used the form of a pre-and post-evaluation design (Abbott et al, 2006;Andreessen et al, 2012;Britton et al, 2013;De Laat et al, 2006;Diby et al, 2005;Gurses et al, 2008;Habich et al, 2012;Hyde & Murphy, 2012;Lee et al, 2010;McMullin et al, 2006;Sinuff et al, 2003;Webb et al, 2006). One study used structured observations (Johansson et al, 2008), 1 used semistructured interviews (Gurses et al, 2008), 1 used record audits (Higuchi et al, 2011), and 1 used a combination of surveys, observations, and focus group interviews (M. Thomas et al, 2010).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…The underlying algorithm was the same as that with the paper protocol, but special alerts were built into the system, and the system also provided suggestions for care. In addition, the program displayed the patient's insulin rate and time for the next glucose check (Lee et al, 2010). One paper described the use of mobile workstations on which shortcuts to clinical guidelines were installed on desktop computers.…”

Section: Effects On the Process Of Care Of Ccgsmentioning

confidence: 99%

Nurses’ Use of Computerized Clinical Guidelines to Improve Patient Safety in Hospitals

et al. 2015

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Computerized clinical guidelines are frequently used to translate research into evidence-based behavioral practices and to improve patient outcomes. The purpose of this integrative review is to summarize the factors influencing nurses' use of computerized clinical guidelines and the effects of nurses' use of computerized clinical guidelines on patient safety improvements in hospitals. The Embase, Medline Complete, and Cochrane databases were searched for relevant literature published from 2000 to January 2013. The matrix method was used, and a total of 16 papers were included in the final review. The studies were assessed for quality with the Critical Appraisal Skills Program. The studies focused on nurses' adherence to guidelines and on improved patient care and patient outcomes as benefits of using computerized clinical guidelines. The nurses' use of computerized clinical guidelines demonstrated improvements in care processes; however, the evidence for an effect of computerized clinical guidelines on patient safety remains limited.

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Computerisation of a paper-based intravenous insulin protocol reduces errors in a prospective crossover simulated tight glycaemic control study

Cited by 21 publications

References 26 publications

Blood glucose control using an artificial pancreas reduces the workload of ICU nurses

Blood glucose control using an artificial pancreas reduces the workload of ICU nurses

Evaluation of a Nurse-Managed Insulin Infusion Protocol

Nurses’ Use of Computerized Clinical Guidelines to Improve Patient Safety in Hospitals

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