Literature DB >> 30462804

Impact of an inpatient multidisciplinary glucose control management program.

Denise P Momesso1, Rubens Carmo Costa Filho1, João Luiz Ferreira Costa1, Felipe Saddy1, Ayla Mesquita1, Marcela Calomeni1, Claudia Dos Santos Silva1, Jacqueline Farret1, Mariana Leon Vasques1, Aline G Santos1, Ana Paula Vieira Cabral1, Dayane Ribeiro1, Luciana Reis1, Maria de Fátima M Muino1, Roberta Santiago Vitorino1, Claudio Amorim Monteiro1, Evandro Tinoco1, Andre Volschan1.   

Abstract

OBJECTIVE: Glycemic control has been increasingly recognized as a critical element in inpatient care, but optimal management of blood glucose in the hospital setting remains challenging. The aims of this study were to describe and evaluate the impact of the implementation of an inpatient multidisciplinary glucose control management program on glucose control in hospitalized patients.
MATERIALS AND METHODS: Retrospective analysis of medical records and glucose monitoring data obtained by point- of-care testing (POCT) in hospitalized patients before (May 2014) and after (June 2015 and May 2017) the implementation of the program.
RESULTS: We analyzed 6888, 7290, and 7669 POCTs from 389, 545, and 475 patients in May 2014, June 2015, and May 2017, respectively. Hyperglycemia (≥ 180 mg/ dL) occurred in 23.5%, 19.6%, and 19.3% POCTs in May 2014, June 2015, and May/2017, respectively (p < 0.001), while severe hyperglycemia (≥ 300 mg/dL) was observed in 2.5%, 2.2%, and 1.8% of them, respectively (p = 0.003). Hyperglycemia (≥ 180 mg/dL) reduced significantly from May 2014 to June 2015 (16.3%, p < 0.001) and from May 2014 to May 2017 (178%, p < 0.001). No significant changes occurred in hypoglycemic parameters.
CONCLUSIONS: The implementation of an inpatient multidisciplinary glucose control management program led to significant reductions in hyperglycemic events. The key elements for this achievement were the development of institutional inpatient glycemic control protocols, establishment of a multidisciplinary team, and continuing educational programs for hospital personnel. Altogether, these actions resulted in improvements in care processes, patient safety, and clinical outcomes of hospitalized patients.

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Year:  2018        PMID: 30462804     DOI: 10.20945/2359-3997000000071

Source DB:  PubMed          Journal:  Arch Endocrinol Metab        ISSN: 2359-3997            Impact factor:   2.309


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