Improving Care of the Hospitalized Patient with Hyperglycemia and Diabetes from the SHM Glycemic Control Task Force PDF Download

Author: Guillermo Umpierrez
Publisher:
ISBN:
Category :
Languages : en
Pages : 83

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Author: Lillian F. Lien
Publisher: Springer Science & Business Media
ISBN: 160761006X
Category : Medical
Languages : en
Pages : 152

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Book Description
Glycemic Control in the Hospitalized Patient: A Comprehensive Clinical Guide is a unique, practical resource for health care providers dealing with hyperglycemia in the inpatient setting. Outlining a hands-on approach used by the Duke University Inpatient Diabetes Management team, the book discusses a wide range of scenarios that occur while treating patients with hyperglycemia, including challenging circumstances such as steroids and tube feeding regimens. Special emphasis is given to insulin therapy. The chapters are written by a group of health care providers with extensive, pioneering experience in hyperglycemia control in the inpatient setting at the Duke University Medical Center. The book includes the most up-to-date scientific evidence and information and is addressed to not only hospitalists and general internists but also endocrinology fellows, residents, nurse practitioners, nurses, and other primary care practitioners who treat patients in the inpatient setting. The focus is clearly on practical, patient-care topics. Glycemic Control in the Hospitalized Patient: A Comprehensive Clinical Guide is a first-of-its kind, comprehensive guide to state-of-the-art inpatient glycemic management.

Author: Boris Draznin
Publisher: American Diabetes Association
ISBN: 1580406572
Category : Medical
Languages : en
Pages : 338

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Book Description
As the number of patients with diabetes increases annually, it is not surprising that the number of patients with diabetes who are admitted to the hospital also increases. Once in the hospital, patients with diabetes or hyperglycemia may be admitted to the Intensive Care Unit, require urgent or elective surgery, enteral or parenteral nutrition, intravenous insulin infusion, or therapies that significantly impact glycemic control (e.g., steroids). Because many clinical outcomes are influenced by the degree of glycemic control, knowledge of the best practices in inpatient diabetes management is extremely important. The field of inpatient management of diabetes and hyperglycemia has grown substantially in the last several years. This body of knowledge is summarized in this book, so it can reach the audience of hospitalists, endocrinologists, nurses and other team members who take care of hospitalized patients with diabetes and hyperglycemia.

Author: Kuan-yi Lin
Publisher:
ISBN:
Category :
Languages : en
Pages :

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Introduction:Hyperglycemia in hospitalized patients often leads to adverse outcomes. Glycemic Management Group may contribute significantly to a close monitoring of in-patients with hyperglycemia and an optimized glycemic control.Methods:A program of In-patients Glucose Management Group has been conducted at Lukang Christian Hospital (LCH), Taiwan, from November 2016 to January 2017. In-patients being referred to the program were those hospitalized patients with blood sugar level over 250 mg/dL for two consecutive tests. The program was aimed to provide assistance to those in-patients from a supporting team comprising metabolic specialist, a dietician and a diabetes educator. To have a better blood glucose control, blood glucose test was conducted four times a day in order to get an evaluation of average glycemic level.Result:A total of 107 In-patients with an average age of patients were 70.6u00b115.7 years old, hospitalized between December 2016 and January 2017, have shown a blood sugar level of >250 mg/dL with an average blood sugar level of 262.9u00b164.6 mg/dL.Results indicated that the average blood glucose level of these In-patients decreased gradually from 262.9u00b1 64.6 mg/dL to 192u00b157.49 mg/dL at 5 days after joining the program. The hypoglycemia rate during hospitalization was 0.8%.Discussion:The In-patient Glycemic Management Group are established in finding ways to control glycemic level trend of In-patients with an ultimate goal of preventing hyperglycemia, although most hypoglycemia events happened in the hospital are not severe.For future studies, we expect to include more in-patients to obtain more objective results, and extend the study period to determine a long term benefit for a positive effect and better outcome after providing the clinical treatment.

Author: U. S. Department of Veterans Affairs
Publisher: Createspace Independent Pub
ISBN: 9781490363844
Category : Medical
Languages : en
Pages : 80

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Hyperglycemia is a common finding among medical and surgical inpatients with and without known diabetes, and is associated with poor outcomes across a variety of inpatient subpopulations. The relationship between hyperglycemia and inpatient outcomes may be weaker in patients with diabetes than in patients without diabetes. Hyperglycemia may be a marker of severe, acute illness, one of many physiological derangements associated with an abundance of counter-regulatory hormones, insulin resistance, and suppression of anabolic pathways. On the other hand, many investigators believe that hyperglycemia itself may worsen outcomes by contributing to inflammation, oxidative stress, poor immune function, and endothelial dysfunction. Interventions to control hyperglycemia in inpatients have largely centered on the use of adjustable insulin infusions to lower blood glucose. An early trial in myocardial infarction patients found that lowering blood glucose using intensive insulin therapy (IIT) reduced long-term mortality, though it remains unclear whether the inpatient or outpatient components of the intervention were responsible for the benefit. An influential single-center observational study of cardiac surgery patients reported reduced wound infection and mortality rates after the introduction of an intensive care unit IIT protocol. Subsequently a single-center trial in critically ill surgical patients suggested a mortality benefit from IIT used to achieve normoglycemia. These findings have fueled widespread interest in inpatient glycemic control strategies, and organizations have called for strict glycemic control strategies to be implemented in a variety of intensive care unit settings. More recently, new trials have been completed that may help clarify the balance of benefits and harms of widespread IIT implementation in intensive care units. We conducted a systematic review of trials and a critical appraisal of frequently cited observational studies to identify strengths of—and gaps in—the evidence supporting broad use of IIT to achieve glycemic control in inpatients. The objectives of this review are to address the following questions: 1. Does the use of intensive insulin therapy (IIT) to achieve tight glycemic control compared to less tight glycemic control improve final health outcomes in the following patients? patients in the surgical intensive care unit, patients in the medical intensive care unit, patients in the perioperative setting, acute myocardial infarction patients, acute stroke patients, general surgical ward patients, general medicine ward patients.2. What are the harms of strict glycemic control in the above subpopulations? 3. What are the most effective and safest means of lowering blood glucose in the above subpopulations?

Author: Rosalie Leman
Publisher:
ISBN:
Category : Evidence-based nursing
Languages : en
Pages : 74

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Author: Crisamar Javellana-Anunciado
Publisher:
ISBN:
Category : Hospital patients
Languages : en
Pages : 116

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This dissertation study examined the relationship of glucose control with clinical outcomes, costs, discharge planning and education. Extant studies showed that hyperglycemia, in the presence or absence of a diabetes diagnosis, is prevalent in hospitalized patients. Hyperglycemia is found in one-third of all hospital admissions and is linked to poor clinical outcomes and increased healthcare costs. Furthermore, clinical evidence suggests that lack of discharge coordination associated with medical errors and readmission. This entire body of work contains three distinct sections: Two manuscripts and a grant proposal. The two manuscripts in this study were based on more current retrospective data at the time of the study. The first manuscript "Inpatient glycemic management: relationship among glucose control, clinical outcomes and costs" discussed the results on glucose control, clinical outcomes and costs by provider groups. The second manuscript "Inpatient glycemic management: team approach in diabetes education and discharge planning" discussed the outcomes of improved discharge planning and coordination with the intervention of the glycemic management team. The grant proposal "Inpatient glycemic management: clinical and economic impact of changing from sliding scale insulin to basal-bolus" was awarded $105,000 funding by a private pharmaceutical company. The study associated with the grant funding was a completely separate study done in collaboration with the grantor.

Author: Celia M. Levesque
Publisher: Elsevier Health Sciences
ISBN: 1455771511
Category : Medical
Languages : en
Pages : 156

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This issue of Critical Care Nursing Clinics, Guest Edited by Celia Levesque RN, MSN, NP-C, CNS-BC, CDE, BC-ADM, from MD Anderson, will focus on Diabetes. Article topics will include Management of Diabetes in the Clinical Setting, Hyperglycemia management after solid organ transplantation, Insulin therapy in the hospitalized patient, Limb salvage for Vetrans with diabetes, and Management of steroid induced hyperglycemia in the ICU.

Author:
Publisher:
ISBN:
Category :
Languages : en
Pages : 23

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Author: Rajlaxmi Bais
Publisher:
ISBN:
Category :
Languages : en
Pages : 0

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" Diabetes is a worldwide epidemic, affecting over 425 million people globally and in the top ten leading causes of death in the United States (WHO, 2018). The number of hospitalized patients with high blood sugar (hyperglycemia) ranges from 22%-46% of non-critically ill patients, and 70-80% of critically ill patients. Inpatient hyperglycemia is associated with increased risk of complications, longer hospital stays, a higher need for intensive care monitoring, and an increased risk for mortality (Corsino et al., 2017). Registered Nurses (RNs) are often responsible for safely managing blood glucose levels in hospitalized patients, but studies have suggested that nurses have inadequate glycemic management knowledge in insulin management and treatment strategies (Modic et al., 2014). The purpose of this evidence-based practice (EBP) project was to assess baseline glycemic management knowledge for inpatient RNs and determine if knowledge can improve for participants after attending an intensive education session on glycemic management. In this EBP project, 74 registered nurses working at an academic medical center in Seattle, Washington completed a twenty-four-question knowledge assessment and a two-question confidence survey (NGKAS) before and after attending a glycemic management education session. Findings suggested that for nurses that had a low baseline knowledge score (below a benchmark of 80%), a 20% improvement in knowledge and confidence took place after attending an intensive glucose management class. There was no correlation between years of experience and knowledge scores. Novice and expert nurses scored similarly in the pre-test, indicating the need for education sessions for all nursing levels. Key words: Glycemic management knowledge, inpatient glucose management, bedside nurses " -- Abstract