Use of a real-time, algorithm-driven, publicly displayed, automated signal to improve insulin prescribing practices.
Diabetes Res Clin Pract. 2019 Aug 30;:107833
Authors: Franco T, Aaronson B, Williams B, Blackmore C
AIM: The clinical andon board (CAB) is a novel electronic surveillance and communication system, which alerts providers to and prompts treatment of dysglycemia. This investigation was designed to determine the CAB's effectiveness in supporting adherence to standardized evidence-based protocols, as well as improving glycemic control.
METHODS: This study was a retrospective pre/post analysis of insulin orders and blood glucose values. We used a Student's t-test for continuous variables and Chi2 for all other variables. This study included patients 18 years or older admitted to the hospital medical service as an inpatient with a length of stay greater than 24 hours and less than 90 days. We used Pearson's correlation coefficient to evaluate the relationship between CAB and blood glucose.
RESULTS: The rate of compliance in prescribing basal insulin for patient with diabetes increased from 56% to 77% (p<0.001). Similarly, compliance rates for prescribing correctional insulin in patients without diabetes increased from 15% to 37% (p<0.001). Performance on the CAB was linearly related to blood glucose (p=0.004), and there was a small statistically (not clinically) significant improvement in mean blood glucose values.
CONCLUSION: This approach is effective in alerting and engaging providers to prescribe insulin in a standardized manner with potential to improve glycemic control.
PMID: 31476347 [PubMed - as supplied by publisher]