Ginde, Savaser, and Camargo (2009) conducted a study to evaluate the communication and early management of emergency department hyperglycemia. A retrospective cohort study design was used and Institutional Review Board’s (IRB) approval was obtained. The population was emergency department (ED) patients at an urban, academic institution with approximately 50,000 annual visits. Using electronic records, they identified patients with a first serum glucose value of > 140 mg/dL. Researchers then categorized these patients into two groups: 140-199 mg/dL and ≥ 200 mg/dL, with < 140 mg/dL normal.
The researchers selected 200 patients from each glucose group using a random number generator, and then two investigators reviewed the charts using standardized …show more content…
(2011) completed a preliminary study in the emergency department at Rush University Medical Center that focused on three questions: Could they further reduce the risk of hypoglycemia by modifying the original ED insulin protocol? Could they couple the ED insulin protocol with prompt initiation of detemir-aspart protocol in admitted patients? Would the length of stay, mean blood glucose, and incidence of hypoglycemia improve with the use of both protocols compared with usual care in the ED and inpatient units? From May 2008 to June 2009, patients with history of type 2 diabetes and point of care glucose > 200 mg/dL were randomized into intervention and usual care groups and consent was obtained by staff. Inclusion and exclusion criteria were set, and the study consisted of two phases. During phase one, intervention group received subcutaneous insulin based on the ED protocol staff was trained on, and the usual care group received treatment for hyperglycemia at the discretion of the ED physician. Those who needed admission were transitioned to basal-bolus insulin therapy, with first dose in the ED if they had not given themselves their basal dose prior to arrival. Those admitted to the hospital entered phase two, with intervention group patients receiving detemir and pre-meal aspart titrated by staff using protocol, and usual care patients receiving care managed by house staff …show more content…
(2009) conducted a study to show that use of an inpatient glycemic control program would benefit patients, decrease morbidity and mortality, decrease length of stay, and reduce hospital costs. The study was done at Seattle’s Harborview Medical Center, a level one regional trauma center with 400 beds. All patients hospitalized on non-critical care wards were included. Patients were considered dysglycemic if they had received subcutaneous insulin or oral hyperglycemic medications and/or had any single glucose level ≥ 125 mg/dL or < 60 mg/dL. A subcutaneous insulin order form was released for elective use. This consisted of using basal, scheduled prandial, and prandial correction dosing, and included prompts and education. An automated daily data report was then made and identified patients with glucose out of range: < 60 mg/dL and any two readings ≥ 180 mg/dL within the prior 24 hours. Finally, this program recruited an advanced practice nurse practitioner and supervising physician to provide staff and patient education on interventions. This helped development into the glycemic control plan, educating primary physicians and other clinicians at time of patient intervention and as continuing
The researchers selected 200 patients from each glucose group using a random number generator, and then two investigators reviewed the charts using standardized …show more content…
(2011) completed a preliminary study in the emergency department at Rush University Medical Center that focused on three questions: Could they further reduce the risk of hypoglycemia by modifying the original ED insulin protocol? Could they couple the ED insulin protocol with prompt initiation of detemir-aspart protocol in admitted patients? Would the length of stay, mean blood glucose, and incidence of hypoglycemia improve with the use of both protocols compared with usual care in the ED and inpatient units? From May 2008 to June 2009, patients with history of type 2 diabetes and point of care glucose > 200 mg/dL were randomized into intervention and usual care groups and consent was obtained by staff. Inclusion and exclusion criteria were set, and the study consisted of two phases. During phase one, intervention group received subcutaneous insulin based on the ED protocol staff was trained on, and the usual care group received treatment for hyperglycemia at the discretion of the ED physician. Those who needed admission were transitioned to basal-bolus insulin therapy, with first dose in the ED if they had not given themselves their basal dose prior to arrival. Those admitted to the hospital entered phase two, with intervention group patients receiving detemir and pre-meal aspart titrated by staff using protocol, and usual care patients receiving care managed by house staff …show more content…
(2009) conducted a study to show that use of an inpatient glycemic control program would benefit patients, decrease morbidity and mortality, decrease length of stay, and reduce hospital costs. The study was done at Seattle’s Harborview Medical Center, a level one regional trauma center with 400 beds. All patients hospitalized on non-critical care wards were included. Patients were considered dysglycemic if they had received subcutaneous insulin or oral hyperglycemic medications and/or had any single glucose level ≥ 125 mg/dL or < 60 mg/dL. A subcutaneous insulin order form was released for elective use. This consisted of using basal, scheduled prandial, and prandial correction dosing, and included prompts and education. An automated daily data report was then made and identified patients with glucose out of range: < 60 mg/dL and any two readings ≥ 180 mg/dL within the prior 24 hours. Finally, this program recruited an advanced practice nurse practitioner and supervising physician to provide staff and patient education on interventions. This helped development into the glycemic control plan, educating primary physicians and other clinicians at time of patient intervention and as continuing