title: Development of a computerized intravenous insulin application (AutoCal) at Kaiser Permanente Northwest, integrated into Kaiser Permanente HealthConnect: impact on safety and nursing workload.
abstract: BACKGROUND
  The electronic medical record, HealthConnect, at the Kaiser Sunnyside Medical Center in the Northwest used scanned paper protocols for intravenous insulin administration. A chart review of 15 patients on intravenous insulin therapy using state-of-the-art paper-based column protocols revealed 40% deviation from the protocol. A time study of experienced nurses computing the insulin dose revealed an average of 2 minutes per calculation per hour to complete.
  
  
  OBJECTIVE
  To improve patient safety and to reduce nursing workload burden with a computerized intravenous insulin calculator application connected to HealthConnect.
  
  
  METHODS
  Using Kaiser iLab developers through innovation funding, a computerized protocol was developed and integrated into HealthConnect, with a computerized tracking system used to store and to analyze intravenous insulin data.
  
  
  RESULTS
  A review of 35 patient charts using computerized insulin infusion tool indicated 100% accuracy in computations with a reduction of nursing workload from 2 minutes to 30 seconds per calculation.
  
  
  CONCLUSIONS
  Development and operationalizing an integrated intravenous insulin calculator into HealthConnect was successfully completed at the Kaiser Sunnyside Medical Center, with 97% nursing satisfaction scores and a promise to generate data on intravenous insulin therapy to refine the protocol.
authors.affiliation: Kaiser Sunnyside Medical Center, Clackamas, OR, USA. christine.olinghouse@kp.org
authors.forename: Christine
authors.initials: C
authors.lastname: Olinghouse
mesh_terms: D001291:Attitude of Health Personnel; D002985:Clinical Protocols; D003201:Computers; D004360:Drug Therapy, Computer-Assisted; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007262:Infusions, Intravenous; D007328:Insulin / Q000008:administration & dosage*; D055641:Mathematical Concepts; D009726:Nurses; D048108:Nursing Informatics; D061214:Patient Safety; D010549:Personal Satisfaction; D012189:Retrospective Studies; D012984:Software; D016526:Workload
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin