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- Quality Improvement Strategies 4
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Search results for "Hospital Medicine"
- Hospital Medicine
Journal Article > Study
National estimates of insulin-related hypoglycemia and errors leading to emergency department visits and hospitalizations.
Geller AI, Shehab N, Lovegrove MC, et al. JAMA Intern Med. 2014;174:678-686.
According to this large study, nearly 100,000 emergency department visits and 30,000 hospitalizations in the United States each year are due to insulin-related hypoglycemia and errors. Patients older than 80 years were found to be at highest risk for these adverse events.
Hardwiring safety into the computer system: one hospital's actions to provide technology support for U-500 insulin.
ISMP Medication Safety Alert! Acute Care Edition. May 5, 2016;21:1-4.
Insulin is a high-alert drug, and its use is becoming more complex due to the insulin resistance in diabetic patients with obesity. This newsletter article describes the experience of one hospital system that worked to ensure safe insulin administration by implementing a strategy that combined single-use pens and health information technology.
Journal Article > Study
An interprofessional qualitative study of barriers and potential solutions for the safe use of insulin in the hospital setting.
Rousseau MP, Beauchesne MF, Naud AS, et al. Can J Diabetes. 2014;38:85-89.
This focus group study among physicians, nurses, and pharmacists in the hospital setting found that variability in practices for inpatient insulin use contributed to adverse events. The authors advocate for a systems approach to insulin management to enhance safety. A past AHRQ WebM&M commentary suggested that a uniform algorithm for insulin administration be implemented in all acute care settings.
Journal Article > Review
Cornish W. Can J Diabetes. 2014;38:94-100.
Insulin is a high-alert medication due to the potential for serious patient harm resulting from inappropriate administration. This review describes tactics to enhance safe insulin use, including improved attention to contraindications, clinical decision support implementation, and education for providers about glycemic control.
ISMP Medication Safety Alert! Acute Care Edition. February 21, 2013;18:1-3.
This newsletter piece recommends strategies to ensure the safe transition from using insulin pens to insulin vials in acute care.
Leeds, UK: Health and Social Care Information Centre; 2018.
This report identified a significant number of medication errors associated with diabetes care in acute hospitals in England and Wales.
Cases & Commentaries
- Web M&M
Curtiss B. Cook, MD; January 2009
Admitted to the hospital for surgery, a man with type 1 diabetes mellitus asked the staff to leave his home insulin pump in place but did not mention that he was adjusting his insulin pump himself based on serial glucose measurements. As the patient was also receiving an intravenous insulin infusion, he developed hypoglycemia.