• Clinical Evidence

Guardian of Glucose, Consider Using an Electronic Algorithm to Achieve Postcardiac Surgery Glycemic Control

Setting: 800-bed hospital, Level II trauma center and regional referral center for tertiary and quaternary care.

Objective

This prospective study compares post-operative glycemic control for cardiac surgery patients before and after implementation of a software-based tool for insulin dosing (EndoTool).

Setting

800-bed hospital, Level II trauma center and regional referral center for tertiary and quaternary care.

Results

  • Time to control in the cardiovascular recovery unit decreased 78% with EndoTool, from 9 hours to just over 2 hours.
  • Percentage of CABG patients who achieved the optimal blood glucose range of 71-150 mg/dL in the cardiovascular intensive care unit more than quadrupled with EndoTool, from 17% to 91.5%.
  • Mean average incidence of hypoglycemia <70 mg/dL decreased 84% with EndoTool, from 3% to 0.48% of blood glucose measurements.

Conclusions

There is overwhelming evidence that a software-based tool for insulin dosing (EndoTool) improves glycemic control for cardiac surgery patients; additional benefits include projected cost savings from decreased length of stay and mortality as well as overall simplicity of use, ability to customize based on service line/patient population, and user support.

Objective

This prospective study compares post-operative glycemic control for cardiac surgery patients before and after implementation of a software-based tool for insulin dosing (EndoTool).

Setting

800-bed hospital, Level II trauma center and regional referral center for tertiary and quaternary care.

Results
  • Time to control in the cardiovascular recovery unit decreased 78% with EndoTool, from 9 hours to just over 2 hours.
  • Percentage of CABG patients who achieved the optimal blood glucose range of 71-150 mg/dL in the cardiovascular intensive care unit more than quadrupled with EndoTool, from 17% to 91.5%.
  • Mean average incidence of hypoglycemia <70 mg/dL decreased 84% with EndoTool, from 3% to 0.48% of blood glucose measurements.
Conclusions

There is overwhelming evidence that a software-based tool for insulin dosing (EndoTool) improves glycemic control for cardiac surgery patients; additional benefits include projected cost savings from decreased length of stay and mortality as well as overall simplicity of use, ability to customize based on service line/patient population, and user support.

References

Authors

Craig Harris, RN, BSN, MPH; Dawn Greene, RN, CCRN, CS.

Source

Published in Nursing Management, Volume 40, Issue 5, p18-22.

Year

2009

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Objective
Setting
Results
Conclusions
References
Objective

This prospective study compares post-operative glycemic control for cardiac surgery patients before and after implementation of a software-based tool for insulin dosing (EndoTool).

Setting

800-bed hospital, Level II trauma center and regional referral center for tertiary and quaternary care.

Results
  • Time to control in the cardiovascular recovery unit decreased 78% with EndoTool, from 9 hours to just over 2 hours.
  • Percentage of CABG patients who achieved the optimal blood glucose range of 71-150 mg/dL in the cardiovascular intensive care unit more than quadrupled with EndoTool, from 17% to 91.5%.
  • Mean average incidence of hypoglycemia <70 mg/dL decreased 84% with EndoTool, from 3% to 0.48% of blood glucose measurements.
Conclusions

There is overwhelming evidence that a software-based tool for insulin dosing (EndoTool) improves glycemic control for cardiac surgery patients; additional benefits include projected cost savings from decreased length of stay and mortality as well as overall simplicity of use, ability to customize based on service line/patient population, and user support.

References

Authors

Craig Harris, RN, BSN, MPH; Dawn Greene, RN, CCRN, CS.

Source

Published in Nursing Management, Volume 40, Issue 5, p18-22.

Year

2009

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