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Hypoglycemia Analysis

Page history last edited by Kendall Rogers 3 years, 11 months ago

UNM has been identified as having high rates of hypoglycemia, this page is to analyze potential contributing factors.

 

 

After hypoglycemic event, capture this data:

pt NPO or eating (NPO always or changed in last 24 hours)

doses of insulin

types of insulin

oral hypoglycemic medications

recent changes in insulin

previous hypoglycemic event in last 48 hours?

nursing variation from orders (skipping insulin doses)

previous hyperglycemic event with correction insulin given

 

 

Potential Hypotheses for hypoglycemia:

not decreasing basal on NPO days

too high of doses on admission

too rapid of escalation of insulin

missed nutritional intact

Renal insufficiency or medications contributing

Lack of response to initial hypoglycemic events

Over response to hyperglycemic event

 

Nursing Assessment:

Missed meals

Additional Insulin admin

Any medications discontinued or decreased in last 24 hours

Recent increase in Creatnine

Recent increase in insulin

Any other factors:

 

Audit Pull Steps

RALS login

hypoglycemia for ranges

Glucose values extremes

table

set date

nursing unit: adult non-icu

 

This brings up all patients below 40 or below - copy over and apply filter

 

Quality Project with Clint

7/28/15:

Submitting Q2 application

Clint: time in September until Sept 23

         November/December as needed

Plan to meet in august to develop audit tool

 

9/3/15

 

3/11/16

complete columns on u/kg for basal and nutritional

complete previous episode hypo

creatnine clearance

fix weights

complete correction within 4 hours

 

Demographics:

age

 

Myths:

admitting diagnosis, both not DKA and not non-diabetics

recent change in diet, NPO pts

 

Truths:

majority on insulin

spectrum but not significantly high or low on admission

 

Process:

documentation

time to resolution

change in orders

type of intervention

 

To determine:

kidney disease percentage

units per kilogram for basal and nutritional

admission hga1c

ratio of basal to nutritional


Back to Glycemic Control Page

 

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