Evaluation of Computer-Based Insulin Infusion Algorithm Compared With a Paper-Based Protocol in the Treatment of Diabetic Ketoacidosis.

Background: Development of computer-based software, termed electronic glucose management system (eGMS), offers an alternative strategy to manage diabetic ketoacidosis (DKA) compared with institution-specific paper protocols by integrating glucose and insulin titration into the electronic medical rec...

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Publicado en:Journal of Pharmacy Technology Vol. 39; no. 2; pp. 82 - 88
Autores principales: Martinez, Heather M., Elwood, Kirsten, Werth, Chris, Sarangarm, Preeyaporn
Formato: research tables/charts Journal Article
Publicado: Sage Publications Inc. Apr2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2023
      vid: 39
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      pub: Sage Publications Inc.
      place: Thousand Oaks, California
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        10.1177/87551225231160050
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        atl: Evaluation of Computer-Based Insulin Infusion Algorithm Compared With a Paper-Based Protocol in the Treatment of Diabetic Ketoacidosis.
      aug:
        au:
          Martinez, Heather M.
          Elwood, Kirsten
          Werth, Chris
          Sarangarm, Preeyaporn
        affil: Department of Pharmacy, University of New Mexico Hospital, Albuquerque, NM, USA
      sug:
        subj:
          Patient Safety Evaluation
          Drug Therapy, Computer Assisted Evaluation
          Software Evaluation
          Algorithms Evaluation
          Insulin Administration and Dosage
          Infusions, Subcutaneous
          Protocols
          Diabetic Ketoacidosis Drug Therapy
          Human
          Retrospective Design
          Hypoglycemia Epidemiology
          Incidence
          Intensive Care Units
          Length of Stay
          Disease Management
          Electronic Health Records
          Infusions, Intravenous
      ab: Background: Development of computer-based software, termed electronic glucose management system (eGMS), offers an alternative strategy to manage diabetic ketoacidosis (DKA) compared with institution-specific paper protocols by integrating glucose and insulin titration into the electronic medical record. Objective: To evaluate the safety and efficacy of eGMS versus a paper-based DKA protocol in an urban academic medical center. Methods: Single-center, retrospective analysis of patients admitted for DKA. The primary objective of this study was the time to transition from intravenous to subcutaneous insulin after resolution of DKA pre- and post-eGMS implementation. Secondary outcomes included incidence of hypoglycemia while on an insulin infusion, intensive care unit (ICU) length of stay, and total hospital length of stay. Results: Time to DKA resolution was similar in both groups with a median time of 8.6 versus 8.8 hours in the paper-based (n = 133) and eGMS groups (n = 84), respectively (P = 0.43). Hypoglycemia occurred more frequently in the paper-based group compared with eGMS during insulin infusion (14 vs 3 patients, P = 0.06). The median ICU (36.5 vs 41.4 hours; P = 0.05) and hospital length of stay (67.9 vs 77.8 hours; P = 0.05) were shorter in the paper-based group compared with the eGMS group. Conclusion and Relevance : Similar rates of DKA resolution were seen for patients managed with a paper-based protocol compared with eGMS. Patients in the paper-based protocol had a shorter ICU and hospital length of stay; however, eGMS had improved clinically relevant safety outcomes.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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