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Safely Converting an Entire Academic Medical Center From Sliding Scale to Basal Bolus Insulin via Implementation of the eGlycemic Management System.

Publication ,  Journal Article
Newsom, R; Patty, C; Camarena, E; Sawyer, R; McFarland, R; Gray, T; Mabrey, M
Published in: Journal of diabetes science and technology
January 2018

OBJECTIVE:Hyperglycemia is common in the inpatient setting and providers frequently rely on sliding scale insulin. This case study reviews the experience of one hospital moving from high utilization of sliding scale to basal bolus insulin therapy. METHOD:This Retrospective Quality Improvement Study describes the journey of clinicians at a 580-bed hospital to convert from high usage of SSI to BBI. Hyperglycemic adult patients prescribed insulin, with/without a diagnosis of diabetes, were included. RESULTS:Data over the first year showed that patients treated with Glucommander (GM) spent more time in the target range of 70-180 mg/dL than patients treated with non-Glucommander (non-GM), with 2,434 fewer hypoglycemic events and 40,589 fewer hyperglycemic events. Prior to implementation of GM, SSI was close to 95%, BBI at 5%. Within the first month of use, 96% usage of BBI was achieved. Reduction of hypoglycemic events (% of BG < 70 mg/dL) by 21% with 2.16% non-GM compared to GM at 1.74% and severe Hypoglycemia (% of BG < 50 mg/dL) by 50% in the ICU 3% non-GM compared to GM at 1.5%. In addition, patients treated with GM had a shorter LOS than patients treated with non-GM by 3.18 days and used 47.4% less point of care tests per patient. CONCLUSION:Glycemic management improved with use of eGMS. The conversion from SSI to BBI enhanced overall patient safety, eliminated the time and effort otherwise required when manually titrating insulin and reduced overall cost of care for patients on insulin therapy.

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Published In

Journal of diabetes science and technology

DOI

EISSN

1932-2968

ISSN

1932-2968

Publication Date

January 2018

Volume

12

Issue

1

Start / End Page

53 / 59

Related Subject Headings

  • Retrospective Studies
  • Quality of Health Care
  • Quality Improvement
  • Practice Patterns, Physicians'
  • Patient Safety
  • Middle Aged
  • Male
  • Insulin
  • Hypoglycemic Agents
  • Hyperglycemia
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Newsom, R., Patty, C., Camarena, E., Sawyer, R., McFarland, R., Gray, T., & Mabrey, M. (2018). Safely Converting an Entire Academic Medical Center From Sliding Scale to Basal Bolus Insulin via Implementation of the eGlycemic Management System. Journal of Diabetes Science and Technology, 12(1), 53–59. https://doi.org/10.1177/1932296817747619
Newsom, Rosalina, Christopher Patty, Emma Camarena, Regina Sawyer, Raymie McFarland, Thomas Gray, and Melanie Mabrey. “Safely Converting an Entire Academic Medical Center From Sliding Scale to Basal Bolus Insulin via Implementation of the eGlycemic Management System.Journal of Diabetes Science and Technology 12, no. 1 (January 2018): 53–59. https://doi.org/10.1177/1932296817747619.
Newsom R, Patty C, Camarena E, Sawyer R, McFarland R, Gray T, et al. Safely Converting an Entire Academic Medical Center From Sliding Scale to Basal Bolus Insulin via Implementation of the eGlycemic Management System. Journal of diabetes science and technology. 2018 Jan;12(1):53–9.
Newsom, Rosalina, et al. “Safely Converting an Entire Academic Medical Center From Sliding Scale to Basal Bolus Insulin via Implementation of the eGlycemic Management System.Journal of Diabetes Science and Technology, vol. 12, no. 1, Jan. 2018, pp. 53–59. Epmc, doi:10.1177/1932296817747619.
Newsom R, Patty C, Camarena E, Sawyer R, McFarland R, Gray T, Mabrey M. Safely Converting an Entire Academic Medical Center From Sliding Scale to Basal Bolus Insulin via Implementation of the eGlycemic Management System. Journal of diabetes science and technology. 2018 Jan;12(1):53–59.
Journal cover image

Published In

Journal of diabetes science and technology

DOI

EISSN

1932-2968

ISSN

1932-2968

Publication Date

January 2018

Volume

12

Issue

1

Start / End Page

53 / 59

Related Subject Headings

  • Retrospective Studies
  • Quality of Health Care
  • Quality Improvement
  • Practice Patterns, Physicians'
  • Patient Safety
  • Middle Aged
  • Male
  • Insulin
  • Hypoglycemic Agents
  • Hyperglycemia