Department of Internal Medicine, Division of Endocrinology and Metabolism, University of California San Diego, San Diego, CA, USA.
Curr Diab Rep. 2022 Sep;22(9):433-440. doi: 10.1007/s11892-022-01481-0. Epub 2022 Aug 2.
This review discusses ways in which the electronic health record (EHR) can offer clinical decision support (CDS) tools for management of inpatient diabetes and hyperglycemia.
The use of electronic order sets can help providers order comprehensive basal bolus insulin regimens that are consistent with current guidelines. Order sets have been shown to reduce insulin errors and hypoglycemia rates. They can also help set glycemic targets, give hemoglobin A1C reminders, guide weight-based dosing, and match insulin regimen to nutritional profile. Glycemic management dashboards allow multiple variables affecting blood glucose to be shown in a single view, which allows for efficient evaluation of glucose trends and adjustment of insulin regimen. With the use glycemic management dashboards, active surveillance and remote management also become feasible. Hypoglycemia prevention and management are another part of inpatient diabetes management that is enhanced by EHR CDS tools. Furthermore, diagnosis and management of diabetic ketoacidosis and hyperglycemia hyperosmolar state are improved with the aid of EHR CDS tools. The use of EHR CDS tools helps improve the care of patients with diabetes and hyperglycemia in the inpatient hospital setting.
本文讨论了电子病历 (EHR) 如何为住院糖尿病和高血糖的管理提供临床决策支持 (CDS) 工具。
电子医嘱集的使用可以帮助医务人员为患者开出符合当前指南的全面基础-餐时胰岛素治疗方案。医嘱集已被证明可以减少胰岛素错误和低血糖发生率。它们还有助于设定血糖目标、提醒糖化血红蛋白值、指导基于体重的剂量调整，并将胰岛素方案与营养状况相匹配。血糖管理仪表板允许在单个视图中显示影响血糖的多个变量，从而可以有效地评估血糖趋势并调整胰岛素方案。使用血糖管理仪表板，还可以实现主动监测和远程管理。EHR CDS 工具还可以预防和管理低血糖，从而加强住院糖尿病患者的管理。此外，EHR CDS 工具有助于改善糖尿病酮症酸中毒和高血糖高渗状态的诊断和管理。EHR CDS 工具的使用有助于改善住院患者的糖尿病和高血糖护理。
