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Updated: Mar 2, 2026
Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Insulin Bolus Calculator in a Pediatric Hospital. Safety and User Perceptions
Mohammad B Ateya1, Ranjit Aiyagari, Colleen Moran
1Ateya, Mohammad B., Health Information Technology & Services, University of Michigan Health System, Ann Arbor, MI, Email: mateya@med.umich.edu, Postal Address: 4251 Plymouth Road, Suite 3300, Ann Arbor, MI 48105-3640.
Insights
A new electronic health record-integrated insulin calculator tool improved care for hospitalized pediatric patients. This tool demonstrated safe insulin dosing and high user satisfaction, streamlining insulin administration without increasing hypoglycemia rates.
Area of Science:
- Pediatric Endocrinology
- Clinical Informatics
- Pharmacology
Background:
- Insulin dosing for hospitalized children is complex, requiring precise adjustments based on clinical and nutritional status.
- Traditional methods can be challenging, necessitating improved tools for accurate insulin delivery.
Purpose of the Study:
- To implement and evaluate a customized subcutaneous insulin bolus dose calculator integrated into the electronic health record for pediatric patients.
- To assess the tool's utilization, safety, user satisfaction, and perceptions.
Main Methods:
- A retrospective comparison of blood glucose results for patients receiving insulin with and without the calculator tool was conducted.
- A survey was administered to users who interacted with the tool to assess satisfaction and perceptions.
- Statistical analysis included comparison of hypoglycemia rates and correlation of Likert scale responses with overall satisfaction.
Main Results:
- Hypoglycemia rates (2.2% vs. 2.9%) and severe hypoglycemia rates (0.04% vs. 0.1%) were not significantly different between groups.
- Overall user satisfaction was high (mean 4.05/5), with physicians reporting slightly higher satisfaction than nurses.
- User agreement that the tool improved care strongly correlated with overall satisfaction (r=0.80).
Conclusions:
- The electronic health record-integrated insulin calculator effectively streamlined insulin ordering and administration in a pediatric setting.
- The tool maintained patient safety and was met with high user satisfaction.
- This technology offers a valuable solution for optimizing insulin therapy in hospitalized pediatric populations.
Background:
Insulin dosing in hospitalized pediatric patients is challenging and requires dosing to be matched with the specific clinical and nutritional circumstances. We implemented a customized subcutaneous insulin bolus dose calculator tool integrated with the electronic health record to improve patient care. Here we describe this tool, its utilization and safety, and assess user satisfaction and perceptions of the tool.
Methods:
Blood glucose results for all patients who received insulin with and without the calculator tool were compared to assess safety. To assess user perceptions and satisfaction, a survey was sent to all identified users who interacted with the tool during the period from May 2015 to the end of November 2015. Survey responses were summarized, mean user satisfaction calculated, and correlation of Likert scale items with overall satisfaction assessed.
Results:
Hypoglycemia rates (2.2% and 2.9%, p = 0.17) and severe hypoglycemia rates (0.04% and 0.1%, p = 0.21) were similar for the groups that received insulin with and without the calculator tool. Overall satisfaction for all survey respondents was high (4.05, SD = 0.83). Physicians indicated a slightly higher satisfaction than nurses (4.33 versus 3.94, p = 0.04). User agreement with improvement of quality of care showed the highest correlation with overall satisfaction (r = 0.80, 95% CI 0.7 - 0.87).
Conclusion:
Implementation of an insulin calculator tool streamlined ordering and administration of insulin in a pediatric academic institution while maintaining patient safety. Users indicated high overall satisfaction with the tool.
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