دورية أكاديمية
أعرض في EDS

Intraoperative blood glucose management: impact of a real-time decision support system on adherence to institutional protocol.

التفاصيل البيبلوغرافية
العنوان: Intraoperative blood glucose management: impact of a real-time decision support system on adherence to institutional protocol.
المؤلفون: Nair BG; Department of Anesthesiology and Pain Medicine, University of Washington, BB-1469 Health Sciences Bldg, 1959 NE Pacific Street, Mail Box: 356540, Seattle, WA, 98195, USA. nairbg@uw.edu., Grunzweig K; School of Medicine, University of Washington, Seattle, WA, USA., Peterson GN; Department of Anesthesiology, Virginia Commonwealth University, Richmond, VA, USA., Horibe M; Department of Anesthesiology and Pain Medicine, University of Washington, BB-1469 Health Sciences Bldg, 1959 NE Pacific Street, Mail Box: 356540, Seattle, WA, 98195, USA., Neradilek MB; The-Mountain-Whisper-Light Statistics, Seattle, WA, USA., Newman SF; Department of Anesthesiology and Pain Medicine, University of Washington, BB-1469 Health Sciences Bldg, 1959 NE Pacific Street, Mail Box: 356540, Seattle, WA, 98195, USA., Van Norman G; Department of Anesthesiology and Pain Medicine, University of Washington, BB-1469 Health Sciences Bldg, 1959 NE Pacific Street, Mail Box: 356540, Seattle, WA, 98195, USA., Schwid HA; Department of Anesthesiology and Perioperative Care, University of California, Irvine, CA, USA., Hao W; Division of Metabolism, Department of Medicine, University of Washington, Seattle, WA, USA., Hirsch IB; Division of Metabolism, Department of Medicine, University of Washington, Seattle, WA, USA., Patchen Dellinger E; Division of General Surgery, Department of Surgery, University of Washington, Seattle, WA, USA.
المصدر: Journal of clinical monitoring and computing [J Clin Monit Comput] 2016 Jun; Vol. 30 (3), pp. 301-12. Date of Electronic Publication: 2015 Jun 12.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Springer Country of Publication: Netherlands NLM ID: 9806357 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-2614 (Electronic) Linking ISSN: 13871307 NLM ISO Abbreviation: J Clin Monit Comput Subsets: MEDLINE
أسماء مطبوعة: Publication: Amsterdam : Springer
Original Publication: Dordrecht, The Netherlands ; Boston : Kluwer Academic Publishers, c1998-
مواضيع طبية MeSH: Decision Support Systems, Clinical*, Blood Glucose/*metabolism , Monitoring, Intraoperative/*methods, Adult ; Aged ; Computer Systems ; Diabetes Mellitus/blood ; Diabetes Mellitus/drug therapy ; Female ; Humans ; Hyperglycemia/blood ; Hyperglycemia/drug therapy ; Infusions, Intravenous ; Insulin/administration & dosage ; Intraoperative Complications/blood ; Intraoperative Complications/drug therapy ; Male ; Middle Aged ; Monitoring, Intraoperative/statistics & numerical data ; Point-of-Care Systems ; Prospective Studies
مستخلص: Poor perioperative glycemic management can lead to negative surgical outcome. Improved compliance to glucose control protocol could lead to better glucose management. An Anesthesia Information Management System based decision support system-Smart Anesthesia Manager™ (SAM) was used to generate real-time reminders to the anesthesia providers to closely adhere to our institutional glucose management protocol. Compliance to hourly glucose measurements and correct insulin dose adjustments was compared for the baseline period (12 months) without SAM and the intervention period (12 months) with SAM decision support. Additionally, glucose management parameters were compared for the baseline and intervention periods. A total of 1587 cases during baseline and 1997 cases during intervention met the criteria for glucose management (diabetic patients or non-diabetic patients with glucose level >140 mg/dL). Among the intervention cases anesthesia providers chose to use SAM reminders 48.7 % of the time primarily for patients who had diabetes, higher HbA1C or body mass index, while disabling the system for the remaining cases. Compliance to hourly glucose measurement and correct insulin doses increased significantly during the intervention period when compared with the baseline (from 52.6 to 71.2 % and from 13.5 to 24.4 %, respectively). In spite of improved compliance to institutional protocol, the mean glucose levels and other glycemic management parameters did not show significant improvement with SAM reminders. Real-time electronic reminders improved intraoperative compliance to institutional glucose management protocol though glycemic parameters did not improve even when there was greater compliance to the protocol.
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فهرسة مساهمة: Keywords: Anesthesia; Blood glucose; Decision support systems; Guideline adherence; Surgery
المشرفين على المادة: 0 (Blood Glucose)
0 (Insulin)
تواريخ الأحداث: Date Created: 20150613 Date Completed: 20170309 Latest Revision: 20181113
رمز التحديث: 20240628
DOI: 10.1007/s10877-015-9718-3
PMID: 26067402
قاعدة البيانات: MEDLINE
الوصف
تدمد:1573-2614
DOI:10.1007/s10877-015-9718-3