Glucose fluctuations, hypoglycemia, and hyperglycemia all contribute to adverse outcomes in hospitalized patients, including increased mortality, morbidity, and length of stay (LOS). The effects of dysglycemia also increase costs to hospitals when patients require more intensive care or longer hospital stays. It may be obvious that patients with diabetes are at risk, but a retrospective review in an Atlanta community hospital showed that newly diagnosed diabetes was an independent risk factor for morbidity and increased hospital LOS, and carried a higher admission rate to the ICU.
Patients whose glucose levels fluctuate as a result of surgery or other trauma may also have compromised outcomes. Hyperglycemia in the hospital is common and, whatever its etiology, associated with poor outcomes. One analysis showed that prevalence of hyperglycemia was 46% for patients in the ICU and 31.7% for non-ICU patients. Careful glucose management may help reduce the clinical and financial impact of impaired glycemic control.
Safety Can Save Costs
Recognition for Effective Control
The Texas Medical Foundation’s Health Quality Institute has recognized URHCS as one of the top 10% of hospitals in the state with effective glucose management protocols.
Close Glucose Management Savings
With the new software, savings were calculated at more than $91,136 in the PCU over the 6-month evaluation period and can help avoid CMS payment loss preventable hospital-acquired manifestations of poor glucose control.
Improved Patient Outcomes
Rate of hypoglycemia (< 70 mg/dL) decreased by 81%; rate of severe hypoglycemia (< 50 mg/dL) decreased by 90%; the percentage of patients “in range” increased to 81.2%; average time to goal was 4.9 hours.
Author(s): Denise Blair, MSN, RN, ACNS-BC, CDE; Laura Zamora, RN; Rodney Brumbelow, PharmD, BCPS; Leo Mercer, MD, FACS
Location: United Regional Health Care System, Wichita Falls, TX
Publication: Nursing Management, December 2012 – Volume 43 – Issue 12 – p 10–12
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