Seheult J N, Pazderska A, Gaffney P, Fogarty J, Sherlock M, Gibney J, Boran G
Clinical Chemistry Department, Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland.
Department of Medicine, Endocrinology Division, Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland.
Int J Endocrinol. 2015;2015:807310. doi: 10.1155/2015/807310. Epub 2015 Jul 28.
Background. Poor inpatient glycaemic control has a prevalence exceeding 30% and results in increased length of stay and higher rates of hospital complications and inpatient mortality. The aim of this study was to improve inpatient glycaemic control by developing an alert system to process point-of-care blood glucose (POC-BG) results. Methods. Microsoft Excel Macros were developed for the processing of daily glucometry data downloaded from the Cobas IT database. Alerts were generated according to ward location for any value less than 4 mmol/L (hypoglycaemia) or greater than 15 mmol/L (moderate-severe hyperglycaemia). The Diabetes Team provided a weekday consult service for patients flagged on the daily reports. This system was implemented for a 60-day period. Results. There was a statistically significant 20% reduction in the percentage of hyperglycaemic patient-day weighted values >15 mmol/L compared to the preimplementation period without a significant change in the percentage of hypoglycaemic values. The time-to-next-reading after a dysglycaemic POC-BG result was reduced by 14% and the time-to-normalization of a dysglycaemic result was reduced from 10.2 hours to 8.4 hours. Conclusion. The alert system reduced the percentage of hyperglycaemic patient-day weighted glucose values and the time-to-normalization of blood glucose.
背景。住院患者血糖控制不佳的发生率超过30%，会导致住院时间延长、医院并发症发生率升高以及住院患者死亡率增加。本研究的目的是通过开发一个警报系统来处理即时检测血糖（POC-BG）结果，以改善住院患者的血糖控制。方法。开发了Microsoft Excel宏程序来处理从Cobas IT数据库下载的每日血糖检测数据。根据病房位置，对任何低于4 mmol/L（低血糖）或高于15 mmol/L（中度至重度高血糖）的值生成警报。糖尿病团队为每日报告中标记的患者提供工作日咨询服务。该系统实施了60天。结果。与实施前相比，血糖高于15 mmol/L的患者日加权值百分比有统计学意义地降低了20%，而低血糖值百分比无显著变化。血糖异常的POC-BG结果后的下次检测时间缩短了14%，血糖异常结果的恢复正常时间从10.2小时缩短至8.4小时。结论。警报系统降低了血糖高于正常的患者日加权血糖值百分比以及血糖恢复正常的时间。
