Use of Continuous Subcutaneous Insulin Infusion (Insulin Pump) Therapy in the Hospital: A Review of One Institution's Experience

Abstract

Abbreviations: (CPOE)

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

“…Per our previous definitions, if CSII therapy was only temporarily suspended or discontinued (typically for 1-2 hours) for a procedure, then restarted and otherwise maintained for the duration of the hospitalization, we designated these patients as having continued CSII therapy. 16,17 …”

“…13,16,17 Thus we retrieved data on age, sex, race or ethnicity, length of hospital stay, type of diabetes, duration of diabetes, and length of time that the patient reported being on CSII therapy. Compliance with process measures was assessed by reviewing the electronic medical record and determining if documentation of the following occurred: nursing staff notation of pump presence at admission, admission glucose measurement, signed patient consent form present in the medical record, standard insulin pump orders completed, endocrinology consultation placed, and, finally, documentation of a completed bedside flow sheet.…”

“…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. 16,17 The purpose of this analysis was to provide updated information relating to the use of inpatient CSII that includes an examination of adherence to our institutional policies over time, assessment of glycemic control, and evaluation of adverse events related to inpatient pump use.…”

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

“…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.…”

“…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.…”