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Use of a standardized protocol to decrease medication errors and adverse events related to sliding scale insulin.

A C Donihi1, M M DiNardo, M A DeVita

  • 1University of Pittsburgh, 302 Scaife Hall, 200 Lothrop Street, Pittsburgh, PA 15213, USA. calabresea@upmc.edu

Quality & Safety in Health Care
|April 6, 2006
PubMed
Summary

Implementing a standardized sliding scale insulin (SSI) protocol reduced prescribing errors and hyperglycemia frequency in hospitalized patients. This improved patient safety and glycemic control, demonstrating the protocol

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Area of Science:

  • Internal Medicine
  • Hospital Administration
  • Patient Safety

Background:

  • Sliding scale insulin (SSI) is a common inpatient hyperglycemia management strategy.
  • SSI use is linked to significant medication errors and adverse events like hypoglycemia and hyperglycemia.

Purpose of the Study:

  • To evaluate the impact of a standardized SSI protocol and preprinted order form on prescribing errors and glycemic control.
  • To assess the effectiveness of a new protocol in reducing adverse events associated with SSI.

Main Methods:

  • An observational before-and-after study was conducted at a university hospital.
  • A standardized SSI protocol and preprinted physician order form were implemented in non-intensive care units.
  • Chart reviews and data analysis were used to compare outcomes before and after implementation.

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Main Results:

  • Physician order form usage reached 91%, with 86% of SSI orders adhering to guidelines within one year.
  • Prescribing errors per 100 SSI patient-days decreased significantly from 10.3 to 1.2 (p=0.03).
  • Hyperglycemia episodes per 100 SSI patient-days dropped from 55.9 to 16.3.

Conclusions:

  • The standardized SSI protocol was well-accepted by hospital staff.
  • Implementation led to a significant reduction in prescribing errors and hyperglycemia frequency.
  • The protocol improved patient safety and glycemic management in the hospital setting.