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农村小型重症监护病房血糖控制的基准评估

Benchmarking blood sugar control in the small rural intensive care unit.

作者信息

McCague Andrew, Bautista Jennifer

机构信息

Intensive Care Unit, Natividad Medical Center, Salinas, CA, USA.

出版信息

Hosp Pract (1995). 2019 Oct;47(4):177-180. doi: 10.1080/21548331.2019.1677408. Epub 2019 Oct 11.

DOI:10.1080/21548331.2019.1677408
PMID:31594430
Abstract

: We sought to determine a benchmark for our blood glucose monitoring and compare our data to published data.: Natividad Medical Center is a 172-bed rural hospital located in Salinas, California.Point of care blood glucose (POC-BG) data was extracted from our EMR for all ICU patients greater than 18 years of age between January 2014 and May 2018. Patient day-weighted mean POC-BGs were calculated for each patient by calculating the average POC-BG per day for each patient. Proportion measurements for each of our measurements groups were recorded (>180 mg/dL, <70 mg/dL, >250 mg/dL and <50 mg/dL). Monthly averages were plotted for visual comparison. Benchmarks were calculated by using 2x Standard Deviation for each measurement group.: A total of 3164 patients were found with 21,006 POC-BG measurements. The average POC-BG was 136 mg/dL and median 119 mg/dL. Proportion measurements of monthly day-weighted mean POC-BGs ranged from 0-1.2%, 5.3-44.8%, 0-0.3% and 0.6-16.5%, respectively for less than 70 mg/dL, greater than 180 mg/dL, less than 50 mg/dL and greater than 250 mg/dL. A 2x Standard Deviation was used to calculate our benchmark cut offs which provides a 95% confidence interval and includes 97.5% when neglecting the lower range. Our calculated benchmark values are 1.2, 38.2, 0.19, and 13.1% respectively for measurement groups less than 70 mg/dL, greater than 180 mg/dL, less than 50 mg/dL and greater than 250 mg/dL.: Here we present data from a small rural hospital in the Western United States. We calculated benchmarks that could be used to track our ongoing hyper/hypoglycemia improvement projects. We found that when compared to published data, our hyper/hypoglycemia data was comparable to national data.

摘要

我们试图确定血糖监测的基准,并将我们的数据与已发表的数据进行比较。

纳蒂维达德医疗中心是一家位于加利福尼亚州萨利纳斯的拥有172张床位的乡村医院。从我们的电子病历中提取了2014年1月至2018年5月期间所有18岁以上重症监护病房患者的即时血糖(POC-BG)数据。通过计算每位患者每天的平均POC-BG来计算每位患者的日加权平均POC-BG。记录了我们每个测量组的比例测量值(>180mg/dL、<70mg/dL、>250mg/dL和<50mg/dL)。绘制每月平均值以进行直观比较。通过使用每个测量组的2倍标准差来计算基准。

共发现3164例患者,有21006次POC-BG测量值。平均POC-BG为136mg/dL,中位数为119mg/dL。日加权平均POC-BG每月的比例测量值在小于70mg/dL、大于180mg/dL、小于50mg/dL和大于250mg/dL时分别为0-1.2%、5.3-44.8%、0-0.3%和0.6-16.5%。使用2倍标准差来计算我们的基准临界值,这提供了95%的置信区间,忽略下限范围时包括97.5%。我们计算出的小于70mg/dL、大于180mg/dL、小于50mg/dL和大于250mg/dL测量组的基准值分别为1.2%、38.2%、0.19%和13.1%。

在此,我们展示了来自美国西部一家小型乡村医院的数据。我们计算了可用于跟踪我们正在进行的高/低血糖改善项目的基准。我们发现,与已发表的数据相比,我们的高/低血糖数据与全国数据相当。

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