Improving Diabetes Care in the Hospital Using Guideline-Directed Orders
- Stephen F. Quevedo, MD, FACP,
- Elaine Sullivan, MS, RN, CDE,
- Randi Kington, MS, APRN, CDE and
- Warren Rogers, RPh
- Address correspondence and reprint requests to Stephen F. Quevedo, MD, Director, Joslin Diabetes Center Affiliate at Lawrence & Memorial Hospital, 50 Faire Harbour Pl., New London, CT 06320.
Abstract
Improving glycemic control for inpatients with diabetes remains a formidable challenge. While the use of inadequate and nonphysiological insulin regimens is widespread, there are many potential barriers to improving physician and nursing hospital practices in this area. This article describes an integrated program that utilizes subcutaneous and intravenous insulin order forms incorporating guidelines that encourage more appropriate insulin therapy in the hospital. This approach has resulted in a significant decrease in one factor associated with suboptimal insulin use for inpatients: reliance on sliding-scale short-acting insulin alone for blood glucose control.
Footnotes
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Stephen F. Quevedo, MD, FACP, is director; Elaine Sullivan, MS, RN, CDE, is center manager; and Randi Kington, MS, APRN, CDE, is an adult nurse practitioner at the Joslin Diabetes Center Affiliate at Lawrence & Memorial Hospital. Warren Rogers, RPh, is director of pharmacy at Lawrence & Memorial Hospital in New London, Conn.
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Note of disclosure: Ms. Kington has received honoraria for speaking engagements from Eli Lilly & Company and is a stock shareholder in Eli Lilly and Pfizer, Inc. Both companies manufacture insulin products for the treatment of diabetes.
- American Diabetes Association
