Effect Of A Targeted Glycemic Management Program On Provider Response To Inpatient Hyperglycemia

Donihi, Amy C.; Gibson, Jolynn M.; Noschese, Michelle; DiNardo, Monica; Koerbel, Glory; Curll, Michelle; Korytkowski, Mary T.

doi:10.4158/ep10330.or

Cited by 20 publications

(15 citation statements)

References 14 publications

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“…For example, Cook et al found computer-based learning modules on inpatient management of diabetes and hyperglycemia to be an acceptable learning format for providers. 13 In three studies, incorporation of provider-lecture seminars and case-based education sessions into a hospitalwide glycemic improvement program resulted in decreased use of sliding scale insulin, 14,15 increased use of basal-bolus-correction insulin, 14,15 greater modification of the glycemic regimen in response to severe hyperglycemia, 16 and improved glycemic control, 14–16 yet hypoglycemia rates were unchanged by these interventions. 14–16 …”

Section: Hospitalwide Policies Development and Implementationmentioning

confidence: 99%

Implementing and Evaluating a Multicomponent Inpatient Diabetes Management Program: Putting Research into Practice

Munoz

Pronovost

Dintzis

et al. 2012

The Joint Commission Journal on Quality and Patient Safety

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Background Strategies for successful implementation of hospitalwide glucose control efforts were addressed in a conceptual model for the development and implementation of an institutional inpatient glucose management program. Conceptual Model Components The Glucose Steering Committee incrementally developed and implemented hospitalwide glucose policies, coupled with targeted education and clinical decision support to facilitate policy acceptance and uptake by staff while incorporating process and outcome measures to objectively assess the effectiveness of quality improvement efforts. The model includes four components: (1) engaging staff and hospital executives in the importance of inpatient glycemic management, (2) educating staff involved in the care of patients with diabetes through structured knowledge dissemination, (3) executing evidence-based inpatient glucose management through development of policies and clinical decision aids, and (4) evaluating intervention effectiveness through assessing process measures, intermediary glucometric outcomes, and clinical and economic outcomes. An educational curriculum for nursing, provider, and pharmacist diabetes education programs and current glucometrics were also developed. Outcomes Overall the average patient-day–weighted mean blood glucose (PDWMBG) was below the currently recommended maximum of 180 mg/dL in patients with diabetes and hyperglycemia, with a significant decrease in PDWMBG of 7.8 mg/dL in patients with hyperglycemia. The program resulted in an 18.8% reduction in hypoglycemia event rates, which was sustained. Conclusion Inpatient glucose management remains an important area for patient safety, quality improvement, and clinical research, and the implementation model should guide other hospitals in their glucose management initiatives.

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Section: Hospitalwide Policies Development and Implementationmentioning

confidence: 99%

Implementing and Evaluating a Multicomponent Inpatient Diabetes Management Program: Putting Research into Practice

Munoz

Pronovost

Dintzis

et al. 2012

The Joint Commission Journal on Quality and Patient Safety

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show abstract

“…Similarly, medical staff reviewed BG measurements and made adjustment to diabetes treatment more often. Donihi et al [24] studied a glycaemic management team who remotely monitored BG measurements and alerted treating teams of the occurrence of severe hyperglycaemia (BG >16.7 mmol/l). In addition, treating staff were aware that patientidentifiable BG data were electronically recorded with the theoretical potential for remote electronic surveillance (which was not performed in this study), which may have encouraged a greater sense of accountability for BG management.…”

Section: Discussionmentioning

confidence: 99%

Glucose alert system improves health professional responses to adverse glycaemia and reduces the number of hyperglycaemic episodes in non‐critical care inpatients

et al. 2018

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“…A more direct approach, in which a multidisciplinary team identifi ed poorly managed hyperglycemia among inpatients and contacted the primary team, showed signifi cant improvements in management and glycemic control of the targeted patients. 20 Meanwhile, greater emphasis on using basal-bolus insulin treatment to achieve tight BG targets may increase risk of hypoglycemia. 21 A peculiar lack of correlation is seen between improved resident confi dence and enhanced knowledge.…”

Section: Discussionmentioning

confidence: 99%

Effect of Case-Based Training for Medical Residents on Confidence, Knowledge, and Management of Inpatient Glycemia

Tamler

Green

Skamagas

et al. 2011

Postgraduate Medicine

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Effect Of A Targeted Glycemic Management Program On Provider Response To Inpatient Hyperglycemia

Cited by 20 publications

References 14 publications

Implementing and Evaluating a Multicomponent Inpatient Diabetes Management Program: Putting Research into Practice

Implementing and Evaluating a Multicomponent Inpatient Diabetes Management Program: Putting Research into Practice

Glucose alert system improves health professional responses to adverse glycaemia and reduces the number of hyperglycaemic episodes in non‐critical care inpatients

Effect of Case-Based Training for Medical Residents on Confidence, Knowledge, and Management of Inpatient Glycemia

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