A Quality Improvement Project for Better Glycemic Control in Hospitalized Patients With Diabetes

Gilman, Judy

doi:10.1177/014572170102700409

Cited by 14 publications

(10 citation statements)

References 1 publication

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“…[8][9][10] These efforts have included establishing inpatient diabetes management teams, increased involvement of nurses and pharmacists in diabetes care, and implementation of standardized order sets. 7,[11][12][13] Medical house staff also play a significant role in the management of diabetes in hospitalized patients at most U.S. hospitals. A study of graduating fourth-year medical students demonstrated gaps in knowledge regarding inpatient diabetes.…”

Section: Introductionmentioning

confidence: 99%

Improving the Management of Diabetes in Hospitalized Patients: The Results of a Computer-Based House Staff Training Program

Vaidya

Hurwitz

Yialamas

et al. 2012

Diabetes Technology & Therapeutics

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Background: Poorly controlled diabetes in hospitalized patients is associated with poor clinical outcomes. We hypothesized that computer-based diabetes training could improve house staff knowledge and comfort for the management of diabetes in a large tertiary-care hospital. Results: A significant increase in comfort levels and knowledge in the management of inpatient diabetes was seen among house staff at all levels of training (P < 0.02), but the increase was smaller for senior house staff compared with junior house staff. Nonsignificant trends suggesting increased use of basal-bolus insulin (P = 0.06) and decreased use of sliding-scale insulin (P = 0.10) were seen following the educational intervention in 2009, whereas no such change was seen in 2008 (P > 0.90). Overall, house staff evaluated the training program as ''very relevant'' and the technology interface as ''good.'' Conclusions: A computer-based diabetes training program can improve the comfort and knowledge of house staff and potentially improve their insulin administration practices at large academic centers.

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Section: Introductionmentioning

confidence: 99%

Improving the Management of Diabetes in Hospitalized Patients: The Results of a Computer-Based House Staff Training Program

Vaidya

Hurwitz

Yialamas

et al. 2012

Diabetes Technology & Therapeutics

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“…The most commonly employed quality improvement (QI) interventions in inpatient glucose management can be divided broadly into the following categories: (1) provider reminder systems and decision support [15, 93–96], (2) automated computer order entry [93, 97–99], (3) prescriber or nursing education [93, 95, 98, 100], and (4) organizational change [93, 96, 101, 102]. Most QI studies have used a multi-faceted approach as outlined by Draznin et al’s conceptual model for systems interventions to improve quality and safety of inpatient glucose management (Fig.…”

Section: Evidence-based Intervention Programs Across the Population Hmentioning

confidence: 99%

The Case for Diabetes Population Health Improvement: Evidence-Based Programming for Population Outcomes in Diabetes

et al. 2017

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Purpose of Review The goal of this review is to describe diabetes within a population health improvement framework and to review the evidence for a diabetes population health continuum of intervention approaches, including diabetes prevention and chronic and acute diabetes management, to improve clinical and economic outcomes. Recent Findings Recent studies have shown that compared to usual care, lifestyle interventions in prediabetes lower diabetes risk at the population-level and that group-based programs have low incremental medial cost effectiveness ratio for health systems. Effective outpatient interventions that improve diabetes control and process outcomes are multi-level, targeting the patient, provider, and healthcare system simultaneously and integrate community health workers as a liaison between the patient and community-based healthcare resources. A multi-faceted approach to diabetes management is also effective in the inpatient setting. Interventions shown to promote safe and effective glycemic control and use of evidence-based glucose management practices include provider reminder and clinical decision support systems, automated computer order entry, provider education, and organizational change. Summary Future studies should examine the cost-effectiveness of multi-faceted outpatient and inpatient diabetes management programs to determine the best financial models for incorporating them into diabetes population health strategies.

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“…4,11,18,19 A quality improvement study aimed to enhance nursing interventions in hospitalized patients with diabetes showed that nurses can deliver premeal insulin at appropriate times when provided with support from an interdisciplinary team. 94 Nurses can also inform residents about the potential benefits and adverse effects of proposed medications. 54 Patients with diabetes should be educated about the following: signs and symptoms of hypoglycemia and hyperglycemia; precipitating factors; prevention; monitoring; treatment; and when to alert a member of the health care staff.…”

Section: The Role Of Nurses In the Treatment Of Long-term Care Residementioning

confidence: 99%

Optimizing Insulin Use in Type 2 Diabetes: Role of Basal and Prandial Insulin in Long-Term Care Facilities

Haas

2007

Journal of the American Medical Directors Association

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A Quality Improvement Project for Better Glycemic Control in Hospitalized Patients With Diabetes

Abstract: By working together with the patient, family, and other staff, nurses can more consistently deliver premeal insulin at appropriate times to help improve glycemic control in the hospitalized patient with diabetes.

Cited by 14 publications

References 1 publication

Improving the Management of Diabetes in Hospitalized Patients: The Results of a Computer-Based House Staff Training Program

Improving the Management of Diabetes in Hospitalized Patients: The Results of a Computer-Based House Staff Training Program

The Case for Diabetes Population Health Improvement: Evidence-Based Programming for Population Outcomes in Diabetes

Optimizing Insulin Use in Type 2 Diabetes: Role of Basal and Prandial Insulin in Long-Term Care Facilities

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