Reducing Hypoglycemia in Critical Care Patients Using a Nurse-Driven Root Cause Analysis Process

Critical Care Nurse
Krista E SheaJames S Krinsley

Abstract

Successful blood glucose control is associated with improved outcomes of critically ill patients. However, insulin treatment can cause hypoglycemia, an important patient safety concern. The Joint Commission has recommended that all episodes of hypoglycemia be evaluated with a root cause analysis. To reduce episodes of hypoglycemia through the analysis of data related to each episode. The interdisciplinary team of the 16-bed critical care unit of a university-affilited teaching hospital developed a process to analyze, in real time, each episode of hypoglycemia (blood glucose level <60 mg/dL), including evaluation of patient risk factors and nursing interventions. The nursing staff integrated the root cause analysis into daily practice. The preimplementation period encompassed 2429 consecutive admissions, and the implementation period encompassed 2608 consecutive admissions. The percentage of patients with hypoglycemia decreased substantially during the implementation period among those without (from 6.15% to 3.78%; P = .001) and with diabetes (from 13.14% to 7.23%; P = .002). Mean blood glucose level decreased during the implementation period among patients without diabetes (P < .001), and did not change significantly among pati...Continue Reading

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Citations

May 12, 2020·Journal of Diabetes Science and Technology·Paulina Cruz
Dec 15, 2020·Current Opinion in Endocrinology, Diabetes, and Obesity·Schafer Boeder, Kristen Kulasa
Dec 2, 2020·Critical Care Medicine·Judith Jacobi

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