Assessing the Impact of an Order Panel Utilizing Weight-Based Insulin and Standardized Monitoring of Blood Glucose for Patients With Hyperkalemia
| Autor: | Susan B. Freeman, Ted Shaikewitz, April A. Cooper, R. Clayton Musser, Tracy L. Setji, Rebecca Herbst, Noppon Setji, Sarah L. Hale, Kelby Brown, Beatrice D. Hong, Jimmy Greenlee |
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| Rok vydání: | 2018 |
| Předmět: |
Blood Glucose
Male Hyperkalemia medicine.medical_treatment Potassium chemistry.chemical_element 030204 cardiovascular system & hematology Hypoglycemia Lower risk 03 medical and health sciences 0302 clinical medicine medicine Electronic Health Records Humans Insulin In patient 030212 general & internal medicine Aged Retrospective Studies Blood glucose monitoring Medical Audit medicine.diagnostic_test business.industry Health Policy Body Weight Middle Aged medicine.disease chemistry Anesthesia Administration Intravenous Female medicine.symptom business Weight based dosing |
| Zdroj: | American Journal of Medical Quality. 33:598-603 |
| ISSN: | 1555-824X 1062-8606 |
| Popis: | Intravenous insulin with glucose is used in urgent treatment for hyperkalemia but has a significant risk of hypoglycemia. The authors developed an order panel within the electronic health record system that utilizes weight-based insulin dosing and standardized blood glucose monitoring to reduce hypoglycemia. As initial evaluation of this protocol, the authors retrospectively compared potassium and blood glucose lowering in patients treated with the weight-based (0.1 units/kg) insulin order panel (n = 195) with those given insulin based on provider judgment (n = 69). Serum potassium lowering did not differ between groups and there was no relationship between dose of insulin and amount of potassium lowering. There was a difference in hypoglycemia rates between groups ( P = .049), with fewer severe hypoglycemic events in the panel (2.56%) than in the non-panel group (10.14%). These data suggest weight-based insulin dosing is equally effective for lowering serum potassium and may lower risk of severe hypoglycemia. |
| Databáze: | OpenAIRE |
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