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Comalley glycemic control

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12 papers 0 to 25 followers Articles related to inpatient glycemic management
By Cheryl O'Malley Internal medicine residency program director At Banner University Medical Center in Phoenix & hospitalist with interest in improving inpatient glycemic control
Sophie Bersoux, Curtiss B Cook, Gail L Kongable, Jianfen Shu, Denise R Zito
OBJECTIVE: Report data on glucose control from 635 U.S. hospitals. METHODS: Point-of-care blood glucose (POC-BG) test data from January through December 2012 from 635 facilities were extracted. Glucose control was evaluated using patient-day-weighted mean POC-BG values. We calculated hypoglycemia and hyperglycemia rates, stratified by presence or absence of intensive care unit (ICU) admission, and we evaluated the relationship between glycemic control and hospital characteristics...
September 2014: Endocrine Practice
Erika Brutsaert, Michelle Carey, Joel Zonszein
Hypoglycemia is common in hospitalized patients and is associated with poor outcomes, including increased mortality. Older individuals and those with comorbidities are more likely to suffer the adverse consequences of inpatient hypoglycemia. Observational studies have shown that spontaneous inpatient hypoglycemia is a greater risk factor for death than iatrogenic hypoglycemia, suggesting that hypoglycemia acts as a marker for more severe illness, and may not directly cause death. Initial randomized controlled trials of intensive insulin therapy in intensive care units demonstrated improvements in mortality with tight glycemic control, despite high rates of hypoglycemia...
July 2014: Journal of Diabetes and its Complications
Kendall M Rogers, Diana J Childers, Jordan Messler, Ann Nolan, Wendy K Nickel, Gregory A Maynard
BACKGROUND: The Society of Hospital Medicine's (SHM's) Glycemic Control Mentored Implementation (GCMI) program, which, like all MI programs, is conducted as an improvement collaborative, is intended to help hospitals improve inpatient glycemic control in diabetic and nondiabetic patients by educating and mentoring quality teams. METHODS: Hospital quality improvement (QI) teams applied for participation in GCMI from 2009 through 2012. Accepted sites were assigned either a hospitalist or endocrinologist mentor to work through the life cycle of a QI project...
March 2014: Joint Commission Journal on Quality and Patient Safety
Dawn E Corl, Sean McCliment, Rachel E Thompson, Louise D Suhr, Brent E Wisse
Nursing care for hospitalized patients with diabetes has become more complex as evidence accumulates that inpatient glycemic control improves outcomes. Previous studies have highlighted challenges for educators in providing inpatient diabetes education to nurses. In this article, the authors show that a unit-based diabetes nurse expert team model, developed and led by a diabetes clinical nurse specialist, effectively increased nurses' confidence and expertise in inpatient diabetes care. Adapting this model in other institutions may be a cost-effective way to improve inpatient diabetes care and safety as well as promote professional growth of staff nurses...
May 2014: Journal for Nurses in Professional Development
Jeffrey A Coto, Karen S Yehle, Karen J Foli
Rising healthcare costs and the management of diabetes are financially straining to healthcare organizations. The study purpose was to examine whether a direct relationship existed between the cost of hospitalization, length of stay, excess admission days, and discharge blood glucose (DC-BG) levels and utilizing a standardized glycemic protocol. A retrospective cohort analysis was conducted of adult diabetes mellitus type 2 (DM-2) patients' pre-diabetic protocol (January 1, 2011-December 31, 2011) and post-diabetic protocol (August 1, 2012-October 31, 2012)...
February 2016: Clinical Nursing Research
Rajesh Rajendran, Gerry Rayman
Glycemic control in hospitalized patients with diabetes requires accurate near-patient glucose monitoring systems. In the past decade, point-of-care blood glucose monitoring devices have become the mainstay of near-patient glucose monitoring in hospitals across the world. In this article, we focus on its history, accuracy, clinical use, and cost-effectiveness. Point-of-care devices have evolved from 1.2 kg instruments with no informatics to handheld lightweight portable devices with advanced connectivity features...
November 2014: Journal of Diabetes Science and Technology
Elena V Varlamov, Mark E Kulaga, Akhil Khosla, Danille L Prime, Nancy J Rennert
Hypoglycemia causes immediate adverse reactions and is associated with unfavorable clinical outcomes and increased health care costs. It is also one of the barriers to optimization of inpatient glycemic control. Prioritizing quality improvement efforts to address hypoglycemia in hospitalized patients with diabetes is of critical importance. Acute illness, hospital routine, and gaps in quality care predispose patients to hypoglycemia. Many of these factors can be minimized when approached from a systems-based perspective...
October 2014: Hospital Practice (Minneapolis)
Greg Maynard, Kristen Kulasa, Pedro Ramos, Diana Childers, Brian Clay, Meghan Sebasky, Ed Fink, Aaron Field, Marian Renvall, Patricia S Juang, Charles Choe, Diane Pearson, Brittany Serences, Suzanne Lohnes
OBJECTIVE: Uncontrolled hyperglycemia and iatrogenic hypoglycemia represent common and frequently preventable quality and safety issues. We sought to demonstrate the effectiveness of a hypoglycemia reduction bundle, proactive surveillance of glycemic outliers, and an interdisciplinary data-driven approach to glycemic management. METHODS: HASH(0x5647949248c8) POPULATION: all hospitalized adult non-intensive care unit (non-ICU) patients with hyperglycemia and/or a diagnosis of diabetes admitted to our 550-bed academic center across 5 calendar years (CYs)...
April 2015: Endocrine Practice
Regine Beliard, Karina Muzykovsky, William Vincent, Bupendra Shah, Evangelia Davanos
OBJECTIVES: To assess knowledge and perceptions of health care workers regarding optimal care for patients with hyperglycemia and identify commonly perceived barriers for the development of a hospital-wide education program. RESEARCH DESIGN AND METHODS: A cross-sectional design was utilized to survey health care workers involved in managing hyperglycemia in an urban, community teaching hospital. Each health care worker received a survey specific to their health care role...
August 2016: Journal of Pharmacy Practice
Carlos E Mendez, Ashar Ata, Joanne M Rourke, Steven C Stain, Guillermo Umpierrez
OBJECTIVE: Hyperglycemia, hypoglycemia, and glycemic variability have been associated with increased morbidity, mortality, and overall costs of care in hospitalized patients. At the Stratton VA Medical Center in Albany, New York, a process aimed to improve inpatient glycemic control by remotely assisting primary care teams in the management of hyperglycemia and diabetes was designed. METHODS: An electronic query comprised of hospitalized patients with glucose values <70 mg/dL or >350 mg/dL is generated daily...
August 2015: Endocrine Practice
Joseph A Aloi, Christopher Mulla, Jagdeesh Ullal, David C Lieb
The management of inpatient hyperglycemia is a focus of quality improvement projects across many hospital systems while remaining a point of controversy among clinicians. The association of inpatient hyperglycemia with suboptimal hospital outcomes is accepted by clinical care teams; however, the clear benefits of targeting hyperglycemia as a mechanism to improve hospital outcomes remain contentious. Glycemic management is also frequently confused with efforts aimed at intensive glucose control, further adding to the confusion...
April 2015: Current Diabetes Reports
Priyathama Vellanki, Rachel Bean, Festus A Oyedokun, Francisco J Pasquel, Dawn Smiley, Farnoosh Farrokhi, Christopher Newton, Limin Peng, Guillermo E Umpierrez
OBJECTIVE: Clinical guidelines recommend point-of-care glucose testing and the use of supplemental doses of rapid-acting insulin before meals and at bedtime for correction of hyperglycemia. The efficacy and safety of this recommendation, however, have not been tested in the hospital setting. RESEARCH DESIGN AND METHODS: In this open-label, randomized controlled trial, 206 general medicine and surgery patients with type 2 diabetes treated with a basal-bolus regimen were randomized to receive either supplemental insulin (n = 106) at bedtime for blood glucose (BG) >7...
April 2015: Diabetes Care
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