Insulin Bolus Calculator in a Pediatric Hospital

Ateya, Mohammad; Aiyagari, Ranjit; Moran, Colleen; Singer, Kanakadurga

doi:10.4338/aci-2016-11-ra-0187

Cited by 11 publications

(10 citation statements)

References 10 publications

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“…[44][45][46] One study was excluded because it was a calculator for the pediatric population. 47 The complete search strategy and results are shown in Figure 2.…”

Section: Resultsmentioning

confidence: 99%

Medical software applications for in-hospital insulin therapy: A systematic review

et al. 2020

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Background In-hospital hyperglycemia (HH) is frequent and related to higher morbidity and mortality. Despite the benefits of HH treatment, glycemic control is often poor and neglected. The use of health applications to support diagnosis and therapy is now incorporated into medical practice. Medical applications for inpatient glycemic management have potential to standardize this handling by the nonspecialist physician. However, related studies are scarce. We aim to evaluate the efficacy in inpatient glycemic control parameters of medical software applications in non-critical care settings. Methods This systematic review on in-hospital insulin applications was performed according to PRISMA guidelines. Data were extracted in triplicate and methodological quality was verified. Specific outcomes of interest were glycemic control efficacy, hypoglycemia risk, length of in-hospital stay, integration with the electronic medical record and healthcare staff acceptance. Results Among the 573 articles initially identified and subsequent revision of the references of each one, seven studies involving six applications were eligible for the review. A better glycemic control was reported with the use of most in-hospital insulin applications in the studies evaluated, but there was no mention of the time to reach the glycemic goal. The risk of hypoglycemia was low. Different reasons influenced the varied acceptance of the use of applications among health professionals. Conclusion The six applications of inpatient insulin therapy in a non-critical care environment proved to be useful and safe compared to the usual management. Medical apps are tools that can help improve the quality of patient care.

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“…[44][45][46] One study was excluded because it was a calculator for the pediatric population. 47 The complete search strategy and results are shown in Figure 2.…”

Section: Resultsmentioning

confidence: 99%

Medical software applications for in-hospital insulin therapy: A systematic review

et al. 2020

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“…Participants answering survey questions had adequate exposure to the CDSS and had used the diabetes CDSS module for at least 12 months. Although there have been studies that assessed the use of CDSS in improving the clinical approach to diabetes, 8,[20][21][22] this is one of the few studies that assess the clinician perceptions toward these interventions. Other studies that assessed the provider satisfaction with the use of CDSS in diabetes management have shown findings similar to ours, with providers endorsing CDSS as important.…”

Section: Discussionmentioning

confidence: 99%

Clinician Perceptions of a Computerized Decision Support System for Pediatric Type 2 Diabetes Screening

et al. 2020

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Objective With the increasing prevalence of type 2 diabetes (T2D) in youth, primary care providers must identify patients at high risk and implement evidence-based screening promptly. Clinical decision support systems (CDSSs) provide clinicians with personalized reminders according to best evidence. One example is the Child Health Improvement through Computer Automation (CHICA) system, which, as we have previously shown, significantly improves screening for T2D. Given that the long-term success of any CDSS depends on its acceptability and its users' perceptions, we examined what clinicians think of the CHICA diabetes module. Methods CHICA users completed an annual quality improvement and satisfaction questionnaire. Between May and August of 2015 and 2016, the survey included two statements related to the T2D-module: (1) “CHICA improves my ability to identify patients who might benefit from screening for T2D” and (2) “CHICA makes it easier to get the lab tests necessary to identify patients who have diabetes or prediabetes.” Answers were scored using a 5-point Likert scale and were later converted to a 2-point scale: agree and disagree. The Pearson chi-square test was used to assess the relationship between responses and the respondents. Answers per cohort were compared using the Mann–Whitney U-test. Results The majority of respondents (N = 60) agreed that CHICA improved their ability to identify patients who might benefit from screening but disagreed as to whether it helped them get the necessary laboratories. Scores were comparable across both years. Conclusion CHICA was endorsed as being effective for T2D screening. Research is needed to improve satisfaction for getting laboratories with CHICA.

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“…There is a strong demand for patient–individual support functions, in particular a dosage calculator. It has to be investigated in a field trial, similar to the studies described in Ateya et al 36 and Kim et al, 37 whether and to what extent the developed platform prevents dosing errors and in which ways it can support physicians.…”

Section: Discussionmentioning

confidence: 99%

User-Centered Development of an Online Platform for Drug Dosing Recommendations in Pediatrics

et al. 2019

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Background Drug therapy in pediatric patients is a complex process. Children are subject to continuous growth and variation in drug-metabolizing enzyme activity, requiring continuous adaption of dosages. In Germany, currently no publicly available database exists that provides evidence-based information on drug dosages in pediatrics. For local drug dosing support, a prototype database has been developed within the Children's Hospital, Erlangen. A user-centered development process was initiated to establish an online platform for evidence-based dosing recommendations, as well as pharmacological and pharmaceutical drug information in pediatrics. Objectives The objectives of the study were to survey the demand for such a platform and to assess the usability of the different versions of the developed system. Methods The developed prototype was evaluated in a pluralistic walkthrough with prospective end users. After a redesign, the second prototype of the online platform underwent an online usability testing based on a tailored questionnaire and the System Usability Scale (SUS) (n = 12). Results Eleven of 12 participants expressed a demand for an online platform for pediatric dosing recommendations. The majority of the participants requested the integration of extended features, such as drug–drug interaction alerts, or information on adverse effects, pharmacokinetics, and pharmacodynamics. Particularly noteworthy is the demand for an online calculator; 5 of a total of 15 participants explicitly requested a calculator for dosages (based on age, weight, body surface) and glomerular filtration rate. The usability of the second prototype was rated “good to excellent” with a median SUS of 81.25. Conclusion Local domain experts demand an online platform for pediatric dosing recommendations. The application of the user-centered design approach enabled the development of a prototype suitable for practical use. Multiple additional required functionalities have been identified, whereby the importance of an online calculator for patient–individual dosing recommendations was particularly emphasized.

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Insulin Bolus Calculator in a Pediatric Hospital

Abstract: Implementation of an insulin calculator tool streamlined ordering and administration of insulin in a pediatric academic institution while maintaining patient safety. Users indicated high overall satisfaction with the tool.

Cited by 11 publications

References 10 publications

Medical software applications for in-hospital insulin therapy: A systematic review

Medical software applications for in-hospital insulin therapy: A systematic review

Clinician Perceptions of a Computerized Decision Support System for Pediatric Type 2 Diabetes Screening

User-Centered Development of an Online Platform for Drug Dosing Recommendations in Pediatrics

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