A systems approach to reducing errors in insulin therapy in the inpatient setting.

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
Richard Hellman

Abstract

To highlight the importance of insulin-related medical errors in causing poor outcomes in a hospital setting and to propose a systems approach for improvement. Evidence reported in the medical literature has identified insulin therapy errors as a large and clinically important problem. Insulin has been labeled as one of the top five "high-risk medications" in the inpatient setting. Although insulin therapy can be lifesaving in the hospital setting, it can be life-threatening if used inappropriately. Widespread major systemic problems, such as heavy patient loads for physicians and nurses, absence of backup checks in critical areas, defective communication and coordination, illegible handwriting, and unawareness of the importance of blood glucose control, create obstacles to appropriate and safe care of patients receiving insulin in the hospital. With thorough analysis of the setting, additional training, collective establishment of goals focused on patient safety, insertion of backup checks in areas susceptible to errors, encouragement of sharing of key clinical information, and, where possible, implementation of electronic medical records, systemic and knowledge-based problems will be minimized and outcomes will improve in ins...Continue Reading

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Citations

Dec 3, 2013·Current Diabetes Reports·Leslie EilandCyrus Desouza
Nov 19, 2010·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·Matthew D McHughLinda H Aiken
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Apr 18, 2012·Diabetic Medicine : a Journal of the British Diabetic Association·C G TaylorG Rayman
Dec 30, 2014·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Greg MaynardSuzanne Lohnes
Feb 11, 2015·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Richard Hellman, Boris Draznin
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Sep 27, 2014·International Journal of Medical Informatics·JaeHo LeeMin-Woo Jo
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May 21, 2009·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Etie S MoghissiUNKNOWN American Diabetes Association
Dec 19, 2012·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Mary KennihanSusan S Braithwaite
Aug 8, 2014·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Richard Hellman
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Feb 2, 2019·Pharmacy : Journal of Pharmacy, Education and Practice·Amie BainZaheer Babar
Apr 2, 2011·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Yannis S GuerraLeon Fogelfeld
Aug 15, 2006·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Richard Hellman
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