|
CONTACT:
MarcyAnderson
Tel: 1.888.971.7953 x4013
Email:
manderson@rals.com
Blood Glucose Benchmarking
Results in U.S. Hospital Intensive Care
Units for 2008 Announced
Crozer-Chester Keystone
Medical Center (PA),
Central DuPage
Hospital (IL),
and
Clarian Arnett
Hospital (IN) are Top Performers in
Program that Included
Over
300 Participating Hospitals and 29.8 Million
Test Results
CHARLOTTESVILLE VA - Medical Automation
Systems has announced the benchmarking
results from 2008 RALS Report, the largest
data repository for hospital blood glucose
measurement in the country. The 2008 results
represent over 300 participating hospitals
and 29.8 million glucose test results. Of
those tests, approximately 7,700,000 were
from the Intensive Care Unit (ICU).
The vast majority of the 5,000,000 patients
admitted to the ICU each year have
hyperglycemia—which is defined by the
American Diabetes Association as generally
>140mg/dL but should be kept as close to 110
mg/dL as possible.1 Hyperglycemia
may be due to the severity of their illness,
a physiologic response to stress or
undiagnosed diabetes mellitus. Effective
control of ICU hyperglycemia has been shown
to improve clinical outcomes by reducing
hospital-acquired infection and other
complications such as myocardial infarction,
ischemic stroke and sepsis.2
Crozer-Chester Keystone
ICUs Earn Top Spot with Mean Glucose of
121.6 mg/dL
The Intensive Care Units at Crozer-Chester
Keystone Medical Center, Philadelphia, PA
earned the top spot from over 300 reporting
hospitals with a mean glucose of 121.6 mg/dL.
According to Eileen Young, Director of
Clinical Utilization and Outcomes at Crozer,
“We have been working very hard at each site
on glycemic control in our ICU’s so we hoped
that our results would be great again this
year. We find the RALS Report interesting
because we currently only have internal
data. Without outside benchmarks, you
really do not know if your goal or
expectations are appropriate. When I can
present feedback from the RALS Report
relative to the performance of other
institutions, the team sees that others can
do it, so they can too. This helps to keep
them focused and to not give up.”
“Without outside benchmarks,
you really do not know if your
goals or expectations are
appropriate.”
Eileen
Young, Director of Clinical Utilization and
Outcomes,
Crozer-Chester Keystone
Medical Center
Dr. Riad Cachecho, the Director of Trauma
and Shock Trauma Unit, stated that glycemic
control at Crozer did not start overnight.
“The project started when the Trauma Service
expressed concerns about blood glucose
control in the critical care areas at Crozer”,
said Dr. Cacheco. “With the invaluable
leadership and cooperation of the Pharmacy,
Director of Endocrinology and the Nursing
leadership they piloted the program at the
Shock Trauma Unit and after demonstrating
its success, disseminated it throughout the
system. It then became part of the VHA TICU
collaborative, with an initial target of 150
mg/dL that later became 120 mg/dL. Crozer
attributes their success to a
multidisciplinary team and focused monthly
ICU meetings. They also embrace
collaborative education and coordination
among nursing, intensivists, clinical
pharmacists, endocrinologists and physician
leaders”, he added.
Central DuPage
Hosptial (IL) Improves Mean Blood Glucose
Level Over 19%
Central DuPage Hosptial in Winfield, IL has
improved their mean blood glucose level over
19% in their ICU from 2006 to 2008,
resulting in a second place finish for 2008
with an ICU mean of 126.4 mg/dL. As
reported by Anne
Drolet APN, Central DuPage Physician
Group, “We use a multidisciplinary team
approach to perform rounds everyday. This
includes, nurses, physicians, and
pharmacists that all work with an end
glucose goal of 85-115 mg/dL in mind.”
“ (our) nurses, physicians,
and pharmacists (that)
all work with an end glucose
goal of 85-115 mg/dL in mind.”
Anne
Drolet APN, Central DuPage Physician
Group
Anne went on to say that the decisions made
at Central DuPage to change order sets, as
well as other improvements have been the
result of input from many physicians and
nurses. When asked about concern over
hypoglyemic events, Toni Beymer, ICU
Manager, stated that all the caregivers in
the ICU know the evidence about
hypoglycemia. The data show a lower rate
of hypoglycemia, making them comfortable
with their current ICU glucose goals. As for
doing so well compared to other hospitals,
Dr. Cooke, the VP for Quality and Safety
stated, “We are thrilled at the progress we
have made over the past three years. We want
to continue to do well. We understand that
our goals are somewhat of a moving target
because the best glucose mean may be
different for different types of patients
within our ICU.”
Clarian Arnett
Credits Automated Insulin Dosing as One of
their Keys to Success
Dr. Shannon Oates, chief Endocrinologist at
Clarian Arnett Hospital in Indiana, (ICU
glucose of 126.5, 3rd place
finisher) stated that their low mean glucose
success stemmed from having the
GlucoStabilizer insulin infusion program.
“The GlucoStabilizer allowing
nurses to have more time to
provide care at the patient
bedside,
and reduces potentially dangerous dosing
calculation error.”
Dr. Shannon Oates, Chief
Endocrinologist, Clarian Arnett Hospital
Dr Oates stated that, “The GlucoStabilizer
technology computerizes the complex
calculations used to determine the proper IV
insulin dosage, improves a patient glucose
control, saves critical staff time and
resources by doing the calculations, thus
allowing nurses to have more time to provide
care at the patient bedside, and reduces
potentially dangerous dosing calculation
errors. The benefit to having IV insulin
infusion is a decrease in the time required
to achieve and maintain blood glucose
targets. It takes significantly less time to
get a patient out of the glucose danger zone
and into the target zone, resulting in
marked improvements in patient outcomes. We
also have targeted 50% dextrose doses for
hypoglycemia that bring patients directly to
the goal blood sugar. In addition, we
worked with our partners in food services
and our menu indicates the carbohydrate
grams for each item.”
References
1. Executive Summary:
Standards of Medical Care in Diabetes-2009.
Diabetes Care 2009; 32 (Suppl 1):S6-12.
2. Van den Berghe G, Wouters
P, Weekers F, et al., Intensive Insulin
Therapy in Critically Ill Patients. New
England Journal of Medicine 2001;
345(19):1359-1367.
About the RALS Report
The RALS Report is a
benchmarking service provided by Medical
Automation Systems and represents the
largest data repository for hospital blood
glucose measurement in the country. Since
2006, the RALS Report has collected over 80
million patient results and has provided
participants with detailed tracking and
trending changes in clinical management of
glucose by patient unit.
About Medical Automation
Systems
(www.masinformatics.com)
Medical Automation Systems,
Inc. is the country’s premier provider of
data management systems used by hospitals to
monitor and manage diagnostic testing
performed at the patient’s bedside. Founded
in 1994, MAS has a presence in over 1,600
U.S. hospitals. The company’s flagship
product, RALS-Plus provides information
management for a wide range of point-of-care
testing devices. Other products include RALS-Web,
providing instant access to POC results
through the hospital intranet; and
RALS-eQuiz, an on-line training tool with
re-certification quizzes and automatic
grading. MAS also support websites that
provide source and reference materials on
the point-of-care industry and glycemic
control protocols. Visit www.pointofcare.net,
and www.glycemiccontrol.net
About Crozer-Chester Keystone
Medical Center
(www.crozer.org/CKHS/)
From its beginning in 1990,
Crozer-Keystone Health System located
minutes from Philadelphia, has been the
dominant provider of health care in Delaware
County, Pennsylvania, northern Delaware, and
part of western New Jersey. The population
covered represents almost a million people.
Crozer-Keystone provides a full spectrum of
wellness, prevention, acute care,
rehabilitation and restorative care to the
community.
About Central DuPage Hospital
(www.cdh.org)
Located in Winfield,
Illinois, Central DuPage Hospital provides a
full range of inpatient and outpatient care
for adults and children, including disease
diagnosis, treatment and prevention. The
hospital houses 313 licensed beds.
Additional outpatient treatment and testing
is available at physician practice sites,
Convenient Care Centers and other facilities
related to Central DuPage Hospital.
About Clarian Arnett Hospital
(www.arnett.com/hospital.html)
As part of Clarian Arnett
Health, Clarian Arnett Hospital brings high
quality health care, and is dedicated to
service, convenience and comfort by
compassionate professionals in a supportive,
family centered, healing environment.
# # # |
