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AACN Adv Crit Care ; 27(3): 274-282, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27959310

RESUMO

Hyperglycemia control is associated with improved outcomes in patients undergoing cardiac surgery. The Surgical Care Improvement Project metric (SCIP-inf-4) was introduced as a performance measure in surgical patients and included hyperglycemia control. Compliance with the SCIP-inf-4 metric remains suboptimal. A novel real-time decision support tool (DST) with guaranteed feedback that is based on the existing electronic medical record system was developed at a tertiary academic center. Implementation of the DST increased the compliance rate with the SCIP-inf-4 from 87.3% to 96.5%. Changes in tested clinical outcomes were not observed with improved metric compliance. This new framework can serve as a backbone for development of quality control processes for other metrics. Further and, ideally, multicenter studies are required to test if implementation of electronic DSTs will translate into improved resource utilization and outcomes for patients.


Assuntos
Glicemia/análise , Procedimentos Cirúrgicos Cardíacos/normas , Enfermagem de Cuidados Críticos/métodos , Tomada de Decisões Assistida por Computador , Hiperglicemia/diagnóstico , Hiperglicemia/tratamento farmacológico , Idoso , Estudos de Casos e Controles , Feminino , Fidelidade a Diretrizes , Humanos , Masculino , Pessoa de Meia-Idade , Minnesota , Valor Preditivo dos Testes , Estudos Retrospectivos , Fatores de Risco
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