Computer Decision Support Software Safely Improves Glycemic Control in the Burn Intensive Unit: A Randomized Controlled Clinical Study

Case Study

Objective

The optimal method for glycemic control in the critically burned patient is unknown. The purpose of this randomized controlled study was to determine the safety and efficacy of computer decision support software (CDSS) to control serum glucose concentration in a burn intensive care unit.

Conclusions

CDSS (EndoTool) improved glycemic control in burn ICU patients by achieving target glucose more often compared to a conservative paper-based nomogram, and no increased risk of hypoglycemic events was identified. This finding is consistent with reported CDSS performance in other critically ill populations. Furthermore, nurses complied with CDSS recommendations more often than the calculated infusion rate from the PP, increasing uniformity in delivery of insulin therapy. Consistent glycemic management will provide increased internal validity for multi-center clinical trials evaluating insulin therapy.

EndoTool in the Burn ICU

Z

Safe & Effective

Glycemic control using CDSS is safe and effective for the critically burned patient.

Higher time in target glucose range

Time in target range improved without increase in hypoglycemic events.

Greater Nurse Compliance

EndoTool provided enhanced consistency in practice, providing standardization among nursing staff.

Publication Information

Author(s): Elizabeth A. Mann, RN, MS, John A. Jones, BS, Steven E. Wolf, MD, and Charles E. Wade, PhD

Location: United States Army Institute of Surgical Research, Brooke Army Medical Center, San Antonio, Texas

Source: Journal of Burn Care & Research; 2011 Mar–Apr; 32(2): 246–255.