Outpatient-to-Inpatient Transition of Insulin Pump Therapy: Successes and Continuing Challenges

Nassar, Adrienne A.; Partlow, Brenda; Boyle, Mary E.; Castro, Janna C.; Bourgeois, Peggy B.; Cook, Curtiss B.

doi:10.1177/193229681000400415

Cited by 29 publications

(39 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…With the development and application of specific procedures to guide their use, CSII technology in the hospital is safe. 5,6,[8][9][10][11] Since our original 2005 publication 2 on inpatient application of insulin pump therapy, we have had increased experience with the use of this technology in the hospital. [8][9][10] This review first summarizes the approach used to transition insulin pump-treated patients from the outpatient to the inpatient setting, and then it provides a synopsis of care provided to 253 cases seen at our institution from 2006 to 2011-the largest and longest experience reported to date on inpatient CSII use.…”

Section: Cont Inuous Subcutaneous Insulin Infusion (Csii)mentioning

confidence: 99%

See 1 more Smart Citation

Transitioning Insulin Pump Therapy from the Outpatient to the Inpatient Setting: A Review of 6 Years' Experience with 253 Cases

Cook

Beer

Seifert

et al. 2012

J Diabetes Sci Technol

Self Cite

View full text Add to dashboard Cite

Section: Cont Inuous Subcutaneous Insulin Infusion (Csii)mentioning

confidence: 99%

“…Commercial software (Medical Automation Systems, Inc., Charlottesville, VA) facilitated the glucometer interface with the electronic laboratory file. [8][9][10] Hemoglobin A1c (HbA1c) values were obtained from chart review.…”

Section: Glycemic Control Datamentioning

confidence: 99%

Transitioning Insulin Pump Therapy from the Outpatient to the Inpatient Setting: A Review of 6 Years' Experience with 253 Cases

Cook

Beer

Seifert

et al. 2012

J Diabetes Sci Technol

Self Cite

View full text Add to dashboard Cite

“…Experiences with implementing the inpatient CSII policy [10][11][12][13] have allowed the authors to anticipate potential challenges related to the introduction of an approach to perioperative insulin pump management. One of the foremost challenges will be the need for ongoing staff education to ensure adherence to protocols.…”

Section: Challengesmentioning

confidence: 99%

“…10 Follow-up analyses indicated that this approach successfully identifies patients who can continue to use insulin pumps in the hospital and that staff and patient compliance with required procedures is generally high. [11][12][13] The authors' experiences with inpatient CSII therapy [11][12][13] has served as a model for constructing processes related to perioperative management of insulin pump therapy. These protocols, along with a brief discussion of some of the safety issues related to perioperative pump use, are summarized here.…”

Section: Introductionmentioning

confidence: 99%

Guidelines for Application of Continuous Subcutaneous Insulin Infusion (Insulin Pump) Therapy in the Perioperative Period

Boyle

Seifert

Beer

et al. 2012

J Diabetes Sci Technol

Self Cite

View full text Add to dashboard Cite

Abbreviations: (CSII) continuous subcutaneous insulin infusion, (PACU) postanesthesia care unit AbstractCase reports indicate that diabetes patients receiving outpatient insulin pump therapy have been allowed to continue treatment during surgical procedures. Although allowed during surgery, there is actually little information in the medical literature on how to manage patients receiving insulin pump therapy during a planned surgical procedure. A multidisciplinary work group reviewed current information regarding the use of insulin pumps in the perioperative period. Although the work group identified safety issues specific to surgical scenarios, it believed that with the use of standardized guidelines and a checklist, continuation of insulin pump therapy during the perioperative period is feasible. A sample set of protocols have been developed and are summarized. A policy outlining clear procedures should be established at the institutional level to guide physicians and other staff if the devices are to be employed during the perioperative period. Additional clinical experience with the technology in surgical scenarios is needed, and consensus should be developed for insulin pump use in the perioperative phases of care.

show abstract

“…In a 6-month study 35 of 220 patients who administered their own regular oral medications, no medication errors occurred. According to a study by Nassar et al, 36 when hospitals have established policies on inpatients' use of insulin pumps, most patients can safely keep using an insulin pump during hospitalization. Currently, no studies have been done on how having patients self-administer their own intravenous therapies affects medication errors.…”

Section: Patient Interventionsmentioning

confidence: 99%

Safety Recommendations for Administering Intravenous Prostacyclins in the Hospital

Kingman

Chin²

2013

Critical Care Nurse

View full text Add to dashboard Cite

P ulmonary arterial hypertension (PAH) is a rare disease characterized by vasoconstriction and proliferation of the small pulmonary arteries, changes that eventually lead to right-sided heart failure and death in most patients who have the disease. 1 When PAH is diagnosed early in the course of the disease, initial treatment usually consists of oral therapy, including phosphodiesterase type 5 inhibitors and endothelin receptor antagonists.2 Intravenous epoprostenol sodium (Flolan), epoprostenol for injection (Veletri), and treprostinil (Remodulin) are intravenous prostacyclins given as continuous infusions in the most advanced cases of PAH.1 Prostacyclins are potent vasodilators, inhibit platelet activation, and have antiproliferative effects on smooth muscle and intimal cells. Intravenous prostacyclins are expensive and require a comprehensive insurance approval process. Once approved, the drugs are commonly started in the hospital at a dose of 1.25 to 2 ng/kg per minute via a dedicated central catheter, and the dose is increased according to the signs and symptoms of PAH Safety Recommendations for Administering Intravenous Prostacyclins in the Hospital MARTHA S. KINGMAN, DNP, FNP-C KELLY CHIN, MD FeatureProstacyclins are a high-risk category of continuous intravenous infusions increasingly used in hospitals to treat advanced pulmonary arterial hypertension, a rare condition characterized by vasoconstriction and vascular proliferation of the pulmonary arteries. Prostacyclins are given in doses of nanograms per kilogram per minute and have a narrow therapeutic dosing range for each patient. Sudden increases or decreases in dose can be life threatening. Previous studies revealed errors in the administration of these high-risk infusions, which in some instances led to serious adverse events, including death. The literature was reviewed for safety measures in administration of high-risk intravenous medications and input was obtained from leading experts in pulmonary arterial hypertension to create a set of safety recommendations for infusion of prostacyclins. (Critical Care Nurse. 2013;33[5]:32-34,36-41) ©2013 American Association of Critical-Care Nurses doi: http://dx.doi. org/10.4037/ccn2013608 This article has been designated for CNE credit. A closed-book, multiple-choice examination follows this article, which tests your knowledge of the following objectives:1. Distinguish between adverse effects of prostacyclins and symptoms of pulmonary artery hypertension 2. Summarize 4 approaches to prevent errors associated with high-risk medications 3. Describe 3 safety recommendations that reduce error during prostacyclin administration and the side effects of the prostacyclin being administered. Dosing is generally highly individualized according to the severity of the disease and how well patients are able to tolerate the side effects of the drug. Common side effects include headache, jaw pain, flushing, nausea, diarrhea, rash, and pain in the extremities.3 Signs and symptoms of PAH include shortness of breath, c...

show abstract

Outpatient-to-Inpatient Transition of Insulin Pump Therapy: Successes and Continuing Challenges

Cited by 29 publications

References 17 publications

Transitioning Insulin Pump Therapy from the Outpatient to the Inpatient Setting: A Review of 6 Years' Experience with 253 Cases

Transitioning Insulin Pump Therapy from the Outpatient to the Inpatient Setting: A Review of 6 Years' Experience with 253 Cases

Guidelines for Application of Continuous Subcutaneous Insulin Infusion (Insulin Pump) Therapy in the Perioperative Period

Safety Recommendations for Administering Intravenous Prostacyclins in the Hospital

Contact Info

Product

Resources

About