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Recognizing hypoglycemia in children through automated adverse-event detection.
Mindy J Dickerman1, Brian R Jacobs, Hima Vinodrao
1Division of Pediatric Critical Care Medicine, St Christopher's Hospital for Children, 3601 A St, Philadelphia, PA 19134, USA. mindy.dickerman@gmail.com
Pediatrics
|March 16, 2011
Summary
Automated electronic health record (EHR) systems effectively detect hypoglycemia adverse events in hospitalized children. This method identified more events than voluntary reporting, especially in neonates and those on insulin.
Area of Science:
- Pediatric Healthcare
- Patient Safety
- Health Informatics
Background:
- Automated adverse-event detection using electronic health record (EHR) triggers is effective for identifying adverse events like hypoglycemia.
- The actual incidence and harm of hypoglycemia-related adverse events in pediatric inpatients are not well understood.
Purpose of the Study:
- To describe the utilization of an automated adverse-event detection system for identifying and classifying hypoglycemia-related adverse events in pediatric inpatients.
- To assess the effectiveness of EHR-driven surveillance in detecting hypoglycemia in hospitalized children.
Main Methods:
- A retrospective observational study analyzed all hypoglycemia triggers from an EHR-based surveillance system over one year at a children's hospital.
- Triggers were reviewed to confirm true adverse events and deviations from the standard of care.
- Clinical and demographic data were examined to identify at-risk patient groups.
Main Results:
- The system generated 1254 hypoglycemia triggers, with 198 confirmed as adverse events (15.8% positive predictive value).
- No hypoglycemia adverse events were detected through the hospital's voluntary incident reporting system.
- Most adverse events occurred in the Neonatal Intensive Care Unit (NICU) (62.1%) and in patients receiving insulin therapy (77.8% hospital-wide).
Conclusions:
- Hypoglycemia is prevalent in hospitalized children, particularly neonates and those treated with insulin.
- An EHR-driven automated system successfully identified hypoglycemia in this pediatric population.
- Automated adverse-event detection shows significant potential for enhancing patient safety programs in healthcare organizations using EHRs.
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