
Guardian of Glucose, Consider Using an Electronic Algorithm to Achieve Postcardiac Surgery Glycemic Control
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.
Authors
Craig Harris, RN, BSN, MPH; Dawn Greene, RN, CCRN, CS.
Source
Published in Nursing Management, Volume 40, Issue 5, p18-22.
Year
2009
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