Update on a Quality Initiative to Standardize Perioperative Care for Continuous Subcutaneous Insulin Infusion Therapy

Area of Science:

• Endocrinology
• Surgical Care

Background:

• Insulin pump therapy requires careful management during surgical procedures.
• Standardized care processes are crucial for patient safety in perioperative settings.

Purpose of the Study:

• To evaluate the effectiveness of a care process model (CPM) for managing patients on insulin pump therapy during elective surgery.
• To assess the impact of the CPM on documentation, glucose monitoring, and safety.

Main Methods:

• Retrospective review of electronic medical records for patients on insulin pump therapy.
• Comparison of care processes before and after CPM implementation.
• Analysis of documentation, glucose monitoring, and adverse events.

Main Results:

• The CPM significantly improved hemoglobin A1c monitoring (73% to 94%) and intraoperative glucose monitoring (57% to 81%).
• Documentation of insulin pump status increased across all perioperative phases.
• No significant difference in glycemic control or adverse events was observed, indicating safety.

Conclusions:

• A standardized care process model (CPM) facilitates safe and successful management of insulin pump therapy during the perioperative period.
• While effective, some processes may require further refinement.
• The findings support the use of standardized approaches for insulin pump management in surgical patients.