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Retrospective cross-sectional study measuring the impact of a computer=based insulin correction protocol and nursing inservicing on diabetes outcomes
This study is a retrospective cross-sectional study at one institution, where the investigators compared diabetic patients admitted to Medicine Services from March-April 2006 (before CPOE was implemented) to patients admitted from October-November 2007 (one year after CPOE implementation). Capillary blood glucose values, Hemoglobin AIC, diabetes medication profile and demographic data were obtained to compare between groups. The investigators hypothesized that a computer-based protocol that emphasizes basal-bolus and correctional insulin orders and excludes sliding scale, in conjunction with nursing personnel inservicing, improves outcomes.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Pre-protocol group | Group admitted 1 (one) month before CPOE protocol changes were made | ||
| Post-protocol group | Group admitted 1 (one) year after CPOE protocol changes were made |
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| Measure | Description | Time Frame |
|---|---|---|
| Mean Inpatient Glucose | Baseline glucose | From day of admission to hospital until day of discharge from hospital |
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of normoglycemic (70 to 150 mg/dl) patient-days | Percentage of inpatient days at glucose target | From day of admission to hospital until day of discharge from hospital |
| Percentage of hyperglycemic patient-days |
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Inclusion Criteria:
Exclusion Criteria:
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Diabetic patients admitted to Medicine Services
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| Name | Affiliation | Role |
|---|---|---|
| Yannis S Guerra, MD | Rush University Hospital/John H Stroger Jr. Hospital | Principal Investigator |
| Krishna Das, MD | John H. Stroger Jr. Hospital | Study Chair |
| Pete Antonopoulos, MD | John H. Stroger Jr. Hospital | Study Chair |
| Irene Benson, RN | John H. Stroger Jr. Hospital | Study Chair |
| Shane Borkowski, MD | John H. Stroger Jr. Hospital | Study Chair |
| Leon Fogelfeld, MD | John H. Stroger Jr. Hospital | Study Chair |
| Melanie Gordon, MD | John H. Stroger Jr. Hospital | Study Chair |
| Betsy Palal, MD | John H. Stroger Jr. Hospital | Study Chair |
| Joana Witsil, MD | John H. Stroger Jr. Hospital | Study Chair |
| Evelyn Lacuesta, MD |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| John H. Stroger Jr. Hospital | Chicago | Illinois | 60612 | United States |
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| ID | Term |
|---|---|
| D003920 | Diabetes Mellitus |
| ID | Term |
|---|---|
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D004700 | Endocrine System Diseases |
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Percentage of inpatient days above glucose target
| From day of admission to hospital until day of discharge from hospital |
| Percentage of Patient-days with glucose less than 70 mg/dl | Percentage of inpatient days below glucose target | From day of admission to hospital until day of discharge from hospital |
| Percentage of Patients with inpatient or recent (less than 6 months) hemoglobin AIC | Percentage of patients with recent A1c | From day of admission to hospital until day of discharge from hospital |
| Length of stay | Number of days inpatient | From day of admission to hospital until day of discharge from hospital |
| Distribution of oral hypoglycemic use | Rate of oral diabetes medication use | From day of admission to hospital until day of discharge from hospital |
| Distribution of type of insulin therapy used | Rate of insulin use | From day of admission to hospital until day of discharge from hospital |
| Percent of patient-days with severe hypoglycemia | Percentage of patient days with glucose below 55 mg/dL | From day of admission to hospital until day of discharge from hospital |
| John H. Stroger Jr. Hospital |
| Study Director |