
Effect of a Computerized Insulin Dose Calculator on the Process of Glycemic Control
Objective
This prospective randomized controlled trial compares glycemic control and nursing satisfaction with a computerized insulin dosing system (EndoTool) to a paper protocol in a cardiovascular surgical intensive care unit.
Setting
400-bed rural community regional referral hospital.
Results
- Percentage of blood glucose measurements in the target range of 80-150 mg/dL was 14.3% higher with EndoTool (70.4% ± 15.2 vs 61.6% ± 17.9).
- Glucose variability was 16.3% lower with EndoTool (35.5 mg/dL ± 18.3 vs 42.3 mg/dL ± 21.2)
- lncidence of hypoglycemia <60 mg/dL was 58.4% lower with EndoTool (4.96% vs 11.92% of patients).
- Mean score for nursing satisfaction was 75% higher with EndoTool (8.4 ± 1.4 vs 4.8 ± 2.4 on a scale of 1 to 10).
- Deviation from protocol was 87% lower with EndoTool (0.39 ± 1.0 vs 3.0 ± 4.3 times per patient).
Conclusions
The process of glycemic control improves with use of a computerized system (EndoTool) over a paper protocol, as evidenced by a greater percentage of blood glucose measurements in the target range, lower glucose variability, fewer hypoglycemia events and higher nursing satisfaction/compliance, leading to a determination that use of EndoTool is best practice for intravenous insulin dosing.
Authors
Cheryl Dumont, RN, PhD, CRNI; Cheryl Bourguignon, RN, PhD.
Source
Published in American Journal of Critical Care, Volume 21, Issue 2, p106-115.
Year
2012
Tags
- Cost Savings
- Healthcare-Associated Infections
- Hospital-Acquired Conditions
- Hyperglycemia Reduction
- Hypoglycemia Reduction
- Length of Stay
- Surgical Site Infections
- Glucose Variability
- Mean Glucose Improvement
- Target Goal Attainment
- Time in Range
- Time on IV Insulin
- Time to Target
- Burn Injury
- Cardiac Surgery
- DKA/HHS Management
- Emergency Department
- Induced Hypothermia
- Intra-op Glucose Management
- Obstetrics/Labor & Delivery
- Pediatrics
- Residual Insulin Adjustment
- BG Check Compliance
- BG Test Reduction
- Nursing Satisfaction
- Protocol Adherence
- Provider Satisfaction
- Workflow Improvements