Implementation of an insulin therapy protocol: Applying the Baldrige approach

Foster, Jillian; Pitts, Wes

doi:10.2146/ajhp080451

Cited by 11 publications

(9 citation statements)

References 1 publication

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“…15 Similar positive results have been reported for insulin order sets, blood culture order sets and acute myocardial infarction order sets. [16][17][18] A 2009 study showed that the adoption of an admission order set for community-acquired pneumonia led to a reduction of in-hospital and 30-day mortality by nearly 33% and had a favourable estimate of cost-effectiveness. 19 We present the first study of an admission order set for patients with liver disease and GI haemorrhage.…”

Section: Discussionmentioning

confidence: 99%

Optimising the care of patients with cirrhosis and gastrointestinal haemorrhage: a quality improvement study

Johnson

Spier

Leff

et al. 2011

Alimentary Pharmacology &Amp; Therapeutics

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Section: Discussionmentioning

confidence: 99%

Optimising the care of patients with cirrhosis and gastrointestinal haemorrhage: a quality improvement study

Johnson

Spier

Leff

et al. 2011

Alimentary Pharmacology &Amp; Therapeutics

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“…Hypertension was defined as blood pressure more than 130/85 mmHg or use of any antihypertensive medication (Victor and Kaplan, 2008). DM was defined by a physician's diagnosis, a fasting plasma glucose level of ≥126 mg dL −1 or use of diabetic medications (Foster and Pitts, 2009). Echocardiography was done for all patients during their hospital stay by one cardiologist.…”

Section: Subjectsmentioning

confidence: 99%

Cardiotrophin-1 in Patients with Acute Myocardial Infarction

Jahromi¹,

Shojaie²,

Madani³

2010

American Journal of Applied Sciences

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Problem statement: Myocardial infarction is the combined result of environmental and personal factors. Prothrombotic factors might play an important role in this phenomenon. Inflammation plays a pivotal role in atherosclerosis and coronary heart disease. Cardiotrophin-1 (CT-1), a member of the IL-6 family of cytokines, was identified as a growth factor for cardiac myocytes that induces cardiomyocyte hypertrophy and stimulates cardiac fibroblasts, protects myocytes from cell death. This study was designed to investigate whether plasma concentration of Cardiotrophin-1 (CT-1), in patients who had the first acute myocardial infarction and to analyze their relationship with traditional cardiovascular risk factors. Approach: This study was carried out on 45 patients with Acute Myocardial Infarction (AMI) in their first 24 h of admission as case group and 36 healthy matched individuals were studied as the control. Plasma level of cardiotrophin-1 was determined by enzymelinked immunosorbent assay and the results were compared. Results: Plasma CT-1 levels in the patients with AMI on admission 615.279±5.109 pmol L −1 were significantly higher than those in the control group 534.767±6.750 pmol L −1 (p = 0.001). Plasma CT-1 level was not correlated with diabetes mellitus, hyperlipidemia, sex, age and smoking. Conclusion: Our findings suggested that high plasma CT-1 level in patients with AMI is indicative of hypercoagulable state that is not related to the traditional cardiovascular risk factors.

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“…1, 18, 20, 21, 23–26, 34, 40–52 Donihi et al described a decrease in insulin prescribing errors and adverse events 1 year after the implementation of a standardized protocol and order set for sliding scale insulin. 40 Through the implementation of these interventions, they report a significant decrease in prescribing errors and a decrease in hyperglycemia with no significant change in incidence of hypoglycemia.…”

Section: Discussionmentioning

confidence: 99%

“…1, 18, 20–23, 40–42 Two groups specifically analyzed the impact of a committee focused on hypoglycemia and diabetes safety. Pasala et al described the impact of a hypoglycemia committee to decrease hypoglycemic events.…”

Section: Discussionmentioning

confidence: 99%

Reduction of Insulin Related Preventable Severe Hypoglycemic Events in Hospitalized Children

Poppy

Retamal-Munoz²,

Cree-Green

et al. 2016

Pediatrics

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OBJECTIVE Insulin is a commonly used, high-risk medication in the inpatient setting. Incorrect insulin administration can lead to preventable hypoglycemic events, which are a significant morbidity in inpatient diabetes care. The goal of this intervention was to decrease preventable insulin-related hypoglycemic events in an inpatient setting in a tertiary care pediatric hospital. METHODS Methods included the institution of several interventions such as nursing and physician education, electronic medical record order sets, electronic communication note templates, and the development of new care guidelines. RESULTS After the institution of multiple interventions, the rate of preventable hypoglycemic events decreased from 1.4 preventable events per 100 insulin days to 0.4 preventable events per 100 insulin days. CONCLUSIONS Through the use of a multi-interventional approach with oversight of a multidisciplinary insulin safety committee, a sustained decreased rate of severe preventable hypoglycemic events in hospitalized pediatric patients receiving insulin was achieved.

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Implementation of an insulin therapy protocol: Applying the Baldrige approach

Abstract: The Baldrige approach was successfully used to implement a standard insulin therapy protocol.

Cited by 11 publications

References 1 publication

Optimising the care of patients with cirrhosis and gastrointestinal haemorrhage: a quality improvement study

Optimising the care of patients with cirrhosis and gastrointestinal haemorrhage: a quality improvement study

Cardiotrophin-1 in Patients with Acute Myocardial Infarction

Reduction of Insulin Related Preventable Severe Hypoglycemic Events in Hospitalized Children

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