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通过实施针对开处方者的决策支持工具降低住院患者低血糖发生率

Inpatient Hypoglycemic Rate Reduction Through the Implementation of Prescriber Targeted Decision Support Tools.

作者信息

Odom Jessica, Goldstein Rebecca

机构信息

Prisma Health, Pharmacy, 701 Grove Road, Greenville, SC, 29605, USA.

出版信息

Curr Diab Rep. 2025 Jan 4;25(1):15. doi: 10.1007/s11892-024-01571-1.

Abstract

PURPOSE OF REVIEW

Hypoglycemia has been shown to increase mortality and length of hospital stay and is now reportable to the Centers for Medicare and Medicaid Services as a quality measure. The purpose of this article is to review clinical decision support (CDS) tools designed to reduce inpatient hypoglycemic events.

RECENT FINDINGS

CDS tools such as order set development, medication alerts, and data visibility have all been shown to be valuable tools in improving glycemic performance. This is especially true for hyperglycemic events with mixed results in hypoglycemia prevention. CDS solutions may be targeted directly to healthcare professionals or to specialty diabetes management teams to reduce hypoglycemia. Not all organizations have the financial resources to develop a diabetes management team so non-interruptive alerts may serve as an important tool to alert health care professionals of individuals with additional risk factors for the development of hypoglycemia. CDS can provide a mechanism to reduce the risk of hypoglycemia in hospitalized individuals. Although new research is promising, more studies are needed to determine future directions including the impact and feasibility of continuous glucose monitoring and predictive models to improve overall glycemic performance.

摘要

综述目的

低血糖已被证明会增加死亡率和住院时间,现在作为一项质量指标需向医疗保险和医疗补助服务中心报告。本文旨在综述旨在减少住院患者低血糖事件的临床决策支持(CDS)工具。

最新发现

诸如医嘱集开发、用药警示和数据可视化等CDS工具,均已被证明是改善血糖控制情况的宝贵工具。对于高血糖事件尤其如此,而在预防低血糖方面结果不一。CDS解决方案可直接针对医疗保健专业人员或专业糖尿病管理团队,以降低低血糖风险。并非所有机构都有财力组建糖尿病管理团队,因此非干扰性警示可能是提醒医疗保健专业人员注意有发生低血糖额外风险因素个体的重要工具。CDS可提供一种机制,降低住院患者发生低血糖的风险。尽管新研究很有前景,但仍需要更多研究来确定未来方向,包括持续血糖监测的影响和可行性以及改善整体血糖控制情况的预测模型。

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