Patient Outcomes after Implementation of a Protocol for Inpatient Insulin Pump Therapy

Noschese, Michelle; DiNardo, Monica; Donihi, Amy C.; Gibson, Jolynn M.; Koerbel, Glory; Saul, Melissa; Stefanović-Račić, Maja; Korytkowski, Mary T.

doi:10.4158/ep09063.orr

Cited by 55 publications

(64 citation statements)

References 13 publications

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“…The only other study examining the topic of inpatient CSII use also noted no significant safety issues. 12 In the current study, a third category of inpatient CSII users was identified, one in which insulin pumps were used intermittently. Others have recognized that patients may not be on insulin pumps for the entire length of their hospital stay.…”

Section: Discussionmentioning

confidence: 99%

“…Since our first publication on this area, others have also presented their approach to inpatient insulin pump management. 12,15 Our earlier reports indicated that our policy and procedures permitted a safe outpatient-to-inpatient transition of CSII therapy. 16,17 Prior reviews involved smaller numbers of individual patients and hospitalizations.…”

Section: Introductionmentioning

confidence: 99%

“…[8][9][10] Limited data suggest that this is the patient's preference as well, and patient satisfaction is high when insulin pump therapy is allowed in the hospital. 11,12 No national data exist on current hospital practices regarding insulin pump use. Likewise, consensus is lacking on how to employ CSII therapy in the hospital setting.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Nassar

Partlow

Boyle

et al. 2010

J Diabetes Sci Technol

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Nassar

Partlow

Boyle

et al. 2010

J Diabetes Sci Technol

View full text Add to dashboard Cite

“…Although the relationship between patient satisfaction, health care utilization and outcomes remains poorly defined, patient satisfaction data may be used to evaluate physicians and determine incentive-based compensation. [14][15][16][17][18].…”

Section: Discussionmentioning

confidence: 99%

Assessing Patient Satisfaction of ProvidersÃ¢ÂÂ Adherence to Inpatient Management with Continuous Subcutaneous Insulin Infusion (CSII) Policy: A Cross-Sectional Study

2015

J Diabetes Metab

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There are unique challenges in managing patients with Continuous Subcutaneous Insulin Infusion (CSII) in the inpatient setting, but these challenges may be mitigated by institutional protocols and staff education. The purpose of our study was to determine the current level of patient satisfaction with the staff's adherence with anthe insulin pump policy and to identify areas for improvement. We hypothesize that the majority of patients will be satisfied with inpatient CSII management, as our institute's insulin pump policy had been implemented with educational sessions one year prior. We created a 20-question survey to assess patient satisfaction in regards to their inpatient CSII management which is governed by a system-wide insulin pump policy. 50 adult patients with both type 1 and type 2 diabetes managed with insulin pumps admitted to the hospital for medical care were surveyed. Fisher's exact test was used to measure the association between categorical variables and satisfaction. Of those surveyed, 78% were satisfied with CSII management in the hospital. However, only 62% of participants answered favorably to the statement which evaluated Emergency Department (ED) staff communication regarding the current insulin pump policy. Therefore, targeted education to Emergency Department (ED) staff regarding the availability of an insulin pump protocol and nursing measures to limit CSII disconnection time may further improve patient satisfaction.

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“…5 Patient satisfaction has been reported to be better if they are allowed to use their pump while in the hospital. 6 However use of the insulin pump in the hospital could also be source of medication errors, confusion among the hospital staff, and potentially harmful patient outcomes. It cannot be assumed that patients on CSII are always fully equipped to manage their insulin pump when faced with challenges during hospitalization.…”

Section: Introductionmentioning

confidence: 99%

Insulin Pump Patient Characteristics and Glucose Control in the Hospitalized Setting

Kannan

Satra

Calogeras

et al. 2014

J Diabetes Sci Technol

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Patients' knowledge of their insulin pumps and glucose control during hospitalization has not been studied. The aim was to study the determinants of glycemic control in patients using continuous subcutaneous insulin infusion (CSII) in the hospital. Three groups of patients were identified: those who did not need any inpatient education and continued on CSII (gorup A), those who received education then continued on CSII (group B), and those for whom CSII was not appropriate and were treated with multiple daily insulin injections (gorup C). We compared the measures of glycemic control between the 3 groups and analyzed which variables impacted glucose control. There were 50 patients, with 51 hospital admissions, 57% males, mean age 48 ± 13 years, 86% had type 1 diabetes (T1DM). The mean DM duration was 26 ± 14 years, mean duration of CSII use was 8.7 ± 6 years, and mean HbA1c was 7.6 ± 1.4%. The mean duration of hospital stay was 5.6 ± 4.6 days. Mean blood glucose (BG) and frequency of hyperglycemia and hypoglycemic events among the 3 groups adjusted for their duration of hospital stay were not statistically different. None of the patients developed diabetic ketoacidosis while using their pump.Stepwise multivariate analysis revealed knowledge of hypoglycemia correction was the single most important predictor of mean BG (P < .001). Patients who received inpatient education performed similarly to patients who did not need inpatient education. Patients who receive inpatient education on CSII fare similar as patients who did not require inpatient education.

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Patient Outcomes after Implementation of a Protocol for Inpatient Insulin Pump Therapy

Cited by 55 publications

References 13 publications

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

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

Assessing Patient Satisfaction of ProvidersÃ¢ÂÂ Adherence to Inpatient Management with Continuous Subcutaneous Insulin Infusion (CSII) Policy: A Cross-Sectional Study

Insulin Pump Patient Characteristics and Glucose Control in the Hospitalized Setting

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Patient Outcomes after Implementation of a Protocol for Inpatient Insulin Pump Therapy

Cited by 55 publications

References 13 publications

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

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

Assessing Patient Satisfaction of ProvidersÃ¢ÂÂ Adherence to Inpatient Management with Continuous Subcutaneous Insulin Infusion (CSII) Policy: A Cross-Sectional Study

Insulin Pump Patient Characteristics and Glucose Control in the Hospitalized Setting

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Product

Resources

About

Assessing Patient Satisfaction of ProvidersÃ¢ÂÂ Adherence to Inpatient Management with Continuous Subcutaneous Insulin Infusion (CSII) Policy: A Cross-Sectional Study