Use of a standardized protocol to decrease medication errors and adverse events related to sliding scale insulin.
Qual Saf Health Care
; 15(2): 89-91, 2006 Apr.
Article
em En
| MEDLINE
| ID: mdl-16585106
ABSTRACT
PROBLEM:
Sliding scale insulin (SSI) is frequently used for inpatient management of hyperglycemia and is associated with a large number of medication errors and adverse events including hypoglycemia and hyperglycemia.DESIGN:
Observational before and after study evaluating the impact of implementation of a standardized SSI protocol and preprinted physician order form.SETTING:
University Hospital in Pittsburgh, PA, USA. STRATEGY FOR CHANGE Guidelines for the use of SSI were created by an interdisciplinary committee and implemented in non-intensive care units. In addition, a preprinted physician order sheet was developed which included the guidelines and an option for ordering one of three standardized insulin sliding scales or a patient specific scale. EFFECT OF CHANGE One year after implementation the physician order form was used for 91% of orders and, overall, 86% of SSI orders followed the guidelines. The number of prescribing errors found on chart review was reduced from 10.3 per 100 SSI patient-days at baseline to 1.2 at 1 year (p = 0.03). The number of hyperglycemia episodes 1 year after implementation decreased from 55.9 to 16.3 per 100 SSI patient-days. LESSONS LEARNT The protocol was readily accepted by hospital staff and was associated with decreased prescribing errors and decreased frequency of hyperglycemia.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Protocolos Clínicos
/
Guias de Prática Clínica como Assunto
/
Diabetes Mellitus Tipo 1
/
Diabetes Mellitus Tipo 2
/
Hiperglicemia
/
Hipoglicemiantes
/
Insulina
/
Erros de Medicação
Tipo de estudo:
Etiology_studies
/
Guideline
Limite:
Humans
País/Região como assunto:
America do norte
Idioma:
En
Ano de publicação:
2006
Tipo de documento:
Article