Christine Olinghouse1. 1. Kaiser Sunnyside Medical Center, Clackamas, OR, USA. christine.olinghouse@kp.org
Abstract
CONTEXT: The electronic medical record, HealthConnect, at the Kaiser Sunnyside Medical Center in the Northwest used scanned paper protocols for intravenous insulin administration. A chart review of 15 patients on intravenous insulin therapy using state-of-the-art paper-based column protocols revealed 40% deviation from the protocol. A time study of experienced nurses computing the insulin dose revealed an average of 2 minutes per calculation per hour to complete. OBJECTIVE: To improve patient safety and to reduce nursing workload burden with a computerized intravenous insulin calculator application connected to HealthConnect. SOLUTION: Using Kaiser iLab developers through innovation funding, a computerized protocol was developed and integrated into HealthConnect, with a computerized tracking system used to store and to analyze intravenous insulin data. OUTCOME: A review of 35 patient charts using computerized insulin infusion tool indicated 100% accuracy in computations with a reduction of nursing workload from 2 minutes to 30 seconds per calculation. CONCLUSION: Development and operationalizing an integrated intravenous insulin calculator into HealthConnect was successfully completed at the Kaiser Sunnyside Medical Center, with 97% nursing satisfaction scores and a promise to generate data on intravenous insulin therapy to refine the protocol.
CONTEXT: The electronic medical record, HealthConnect, at the Kaiser Sunnyside Medical Center in the Northwest used scanned paper protocols for intravenous insulin administration. A chart review of 15 patients on intravenous insulin therapy using state-of-the-art paper-based column protocols revealed 40% deviation from the protocol. A time study of experienced nurses computing the insulin dose revealed an average of 2 minutes per calculation per hour to complete. OBJECTIVE: To improve patient safety and to reduce nursing workload burden with a computerized intravenous insulin calculator application connected to HealthConnect. SOLUTION: Using Kaiser iLab developers through innovation funding, a computerized protocol was developed and integrated into HealthConnect, with a computerized tracking system used to store and to analyze intravenous insulin data. OUTCOME: A review of 35 patient charts using computerized insulin infusion tool indicated 100% accuracy in computations with a reduction of nursing workload from 2 minutes to 30 seconds per calculation. CONCLUSION: Development and operationalizing an integrated intravenous insulin calculator into HealthConnect was successfully completed at the Kaiser Sunnyside Medical Center, with 97% nursing satisfaction scores and a promise to generate data on intravenous insulin therapy to refine the protocol.
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