Clinical Evidence

Taking Control of Hyperglycemia to Improve Patient Care: How One Hospital Resolved a Low Benchmark Indicator and Became a Best Practice Site Through Use of EndoTool Glycemic Control Software

Setting: 71-bed full-service community hospital

Objective

This study compares glycemic outcomes before and after implementation of glycemic control software (EndoTool) for patients receiving intravenous insulin, all of whom were previously treated using a paper algorithm.

Setting

71-bed full-service community hospital.

Results

Incidence of hypoglycemia <70 mg/dL decreased 80% with EndoTool, from 4% to 0.8% of blood glucose readings.
Incidence of hyperglycemia >200 mg/dL decreased 53.8% with EndoTool, from 26% to 12% of blood glucose readings.
Mean glucose housewide decreased 21.7 mg/dL with EndoTool, from 183.9 to 162.2 mg/dL, while mean glucose within intensive care units decreased 20.1 mg/dL with EndoTool, from 184.1 to 147.1 mg/dL, achieving top performer status in the Remote Automated Laboratory System (RAL) benchmarking program.
Average time to achieve two consecutive blood glucose readings <150 mg/dL was 4.8 hours with EndoTool.
Average length of stay for DKA patients decreased from 3.3 to 2.66 days with EndoTool, representing an estimated $3,615.16 cost savings per patient and $74,932.41 cost savings per year.

Conclusions

Use of glycemic control software (EndoTool) allows better and more rapid glucose control than a paper algorithm and, according to physicians and nurses, makes transitioning from intravenous to subcutaneous insulin much easier.

Objective

This study compares glycemic outcomes before and after implementation of glycemic control software (EndoTool) for patients receiving intravenous insulin, all of whom were previously treated using a paper algorithm.

Setting

71-bed full-service community hospital.

Results

Incidence of hypoglycemia <70 mg/dL decreased 80% with EndoTool, from 4% to 0.8% of blood glucose readings.
Incidence of hyperglycemia >200 mg/dL decreased 53.8% with EndoTool, from 26% to 12% of blood glucose readings.
Mean glucose housewide decreased 21.7 mg/dL with EndoTool, from 183.9 to 162.2 mg/dL, while mean glucose within intensive care units decreased 20.1 mg/dL with EndoTool, from 184.1 to 147.1 mg/dL, achieving top performer status in the Remote Automated Laboratory System (RAL) benchmarking program.
Average time to achieve two consecutive blood glucose readings <150 mg/dL was 4.8 hours with EndoTool.
Average length of stay for DKA patients decreased from 3.3 to 2.66 days with EndoTool, representing an estimated $3,615.16 cost savings per patient and $74,932.41 cost savings per year.

Conclusions

Use of glycemic control software (EndoTool) allows better and more rapid glucose control than a paper algorithm and, according to physicians and nurses, makes transitioning from intravenous to subcutaneous insulin much easier.

References

Authors

Sondra Boecker, RN, CDE; Linda Barhorst, BSN, CDE.

Source

Presented at EndoTool® User Group Meeting.

Year

2013

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Objective

This study compares glycemic outcomes before and after implementation of glycemic control software (EndoTool) for patients receiving intravenous insulin, all of whom were previously treated using a paper algorithm.

Setting

71-bed full-service community hospital.

Results

Incidence of hypoglycemia <70 mg/dL decreased 80% with EndoTool, from 4% to 0.8% of blood glucose readings.
Incidence of hyperglycemia >200 mg/dL decreased 53.8% with EndoTool, from 26% to 12% of blood glucose readings.
Mean glucose housewide decreased 21.7 mg/dL with EndoTool, from 183.9 to 162.2 mg/dL, while mean glucose within intensive care units decreased 20.1 mg/dL with EndoTool, from 184.1 to 147.1 mg/dL, achieving top performer status in the Remote Automated Laboratory System (RAL) benchmarking program.
Average time to achieve two consecutive blood glucose readings <150 mg/dL was 4.8 hours with EndoTool.
Average length of stay for DKA patients decreased from 3.3 to 2.66 days with EndoTool, representing an estimated $3,615.16 cost savings per patient and $74,932.41 cost savings per year.

Conclusions

Use of glycemic control software (EndoTool) allows better and more rapid glucose control than a paper algorithm and, according to physicians and nurses, makes transitioning from intravenous to subcutaneous insulin much easier.