Salamah Carole, Byxbe Tara, Naffe Aster, Vish Nancy, Dejong Sandra, Muldoon Mary, Cheng Dunlei, Adams Jenny
Baylor Jack and Jane Hamilton Heart and Vascular Hospital, Dallas, Texas (Salamah, Byxbe, Naffe, Vish, DeJong, Muldoon, Adams), and the Institute for Health Care Research and Improvement, Baylor Health Care System, Dallas, Texas (Cheng).
Proc (Bayl Univ Med Cent). 2011 Jan;24(1):3-5. doi: 10.1080/08998280.2011.11928672.
We initiated a study at Baylor Jack and Jane Hamilton Heart and Vascular Hospital to compare the sliding scale insulin (SSI) protocol used in 2006 with the SSI protocol currently used to treat diabetic patients admitted for procedures or surgery. An audit of patients' records revealed greater variation in staff compliance with the current protocol than with the previous one. In addition, it seemed that more patients were refusing insulin coverage under the current protocol than under the prior version. Although the study was aborted, the initial findings motivated us to identify obstacles to glucose control and to launch a health care improvement initiative to increase compliance with the SSI protocol. As a result of this process, the hospital has made several changes, including re-educating staff nurses, initiating competency checks of protocol interpretation, promoting patient education, and implementing early identification of inconsistent glucose control.
我们在贝勒杰克和简·汉密尔顿心脏与血管医院开展了一项研究，以比较2006年使用的滑动比例胰岛素（SSI）方案与目前用于治疗因手术或操作入院的糖尿病患者的SSI方案。对患者记录的审查发现，与之前的方案相比，工作人员对当前方案的依从性差异更大。此外，似乎与之前版本相比，更多患者在当前方案下拒绝胰岛素覆盖。尽管该研究中止了，但初步结果促使我们确定血糖控制的障碍，并发起一项医疗保健改进倡议，以提高对SSI方案的依从性。通过这一过程，医院做出了多项改变，包括对 staff nurses 进行再教育、对方案解读进行能力检查、促进患者教育以及实施对血糖控制不一致情况的早期识别。
