McGauran Joseph, Dart Arianna, Reilly Phyllis, Widdowson Matthew, Boran Gerard
Trinity College, Dublin, Ireland.
Tallaght University Hospital, Dublin, Ireland.
Ir J Med Sci. 2024 Dec;193(6):2773-2779. doi: 10.1007/s11845-024-03768-5. Epub 2024 Aug 5.
Dysglycaemia in hospitalised patients is associated with poorer clinical outcomes, including cardiovascular events, longer hospital stays, and increased risk of mortality. Therefore, glucose monitoring is necessary to achieve best outcomes.
This audit assesses use of point-of-care (POC) blood glucose (BG) testing in Tallaght University Hospital (TUH) over an 8-day period. It evaluates compliance with international and TUH glucose monitoring protocols and determines frequency of diabetes team consultations for inpatient adults.
Data from an 8-day period (12/03/2023-19/03/2023) were extracted from the TUH COBAS-IT system and analysed. Invalid tests were excluded. Hyperglycaemia was defined as ≥ 10 mmol/L and hypoglycaemia as ≤ 3.9 mmol/L. Persistent hyperglycaemia was defined as two BG results of ≥ 10 mmol/L. A chart review was conducted on adult patients with persistent hyperglycaemia to assess for HbA1C results, diabetes diagnosis, and diabetes consult.
3,530 valid tests were included and analysed. 674 individual patients had tests done. 1,165 tests (33.00%) were hyperglycaemic and 75 (2.12%) were hypoglycaemic. 68.25% of adults with persistent hyperglycaemia had an HbA1C test performed or documented within three months. 42.71% of inpatient adults with persistent hyperglycaemia and a known diabetes diagnosis received a consult from the diabetes team.
Increased adherence to hospital protocols for testing HbA1C in adults with persistent hyperglycaemia could improve treatment and clinical outcomes. Increased diabetes team consultation could facilitate appropriate treatment and improve patient outcomes in persistently hyperglycaemic adult patient populations.
住院患者血糖异常与较差的临床结局相关,包括心血管事件、住院时间延长和死亡风险增加。因此,进行血糖监测对于实现最佳治疗效果至关重要。
本次审核评估了塔拉赫特大学医院(TUH)在8天内即时检测(POC)血糖(BG)的使用情况。它评估了对国际和TUH血糖监测方案的依从性,并确定了成年住院患者糖尿病团队会诊的频率。
从TUH COBAS-IT系统中提取并分析了8天(2023年3月12日至2023年3月19日)的数据。排除无效检测。高血糖定义为≥10 mmol/L,低血糖定义为≤3.9 mmol/L。持续性高血糖定义为两次BG结果≥10 mmol/L。对持续性高血糖的成年患者进行病历审查,以评估糖化血红蛋白(HbA1C)结果、糖尿病诊断和糖尿病会诊情况。
纳入并分析了3530次有效检测。674名个体患者进行了检测。1165次检测(33.00%)为高血糖,75次检测(2.12%)为低血糖。持续性高血糖的成年人中,68.25%在三个月内进行了HbA1C检测或有相关记录。持续性高血糖且已知患有糖尿病的成年住院患者中,42.71%接受了糖尿病团队的会诊。
对于持续性高血糖的成年人,提高对医院HbA1C检测方案的依从性可以改善治疗和临床结局。增加糖尿病团队会诊可以促进对持续性高血糖成年患者群体的适当治疗并改善患者结局。