title: Improving glycemic control with the adjunct use of a data management software program.
abstract: BACKGROUND
  Published studies have supported the implementation of tight glucose control (TGC) programs to improve patient outcomes and reduce mortality rates. However, measuring a program's efficiency is challenging, because of a lack of systems that capture data, allow access to data, and support analysis and interpretation in a near prospective time frame. We hypothesized that providing clinicians access to real-time blood glucose (BG) results reports could improve the efficacy of our TGC program.
  
  
  METHODS
  We performed a retrospective review of BG data during a 12-month period in a surgical trauma intensive care unit at a level I trauma center. A unit-specific insulin algorithm was used throughout the study. We compared BG values before and after the implementation of a data management software program that allowed clinicians access to real-time BG results reports. Reports were run daily and weekly to monitor the unit's TGC program.
  
  
  RESULTS
  A total of 70 616 BG values from 1044 patients were analyzed. An overall decrease was observed in the BG level mean, from 121 mg/dL to 112 mg/dL (P < .001), as well as a decrease in the aggregated mean across patients, from 132 mg/dL to 119 mg/dL (P < .001), after implementation of the software. The percentage of values within the target range of 80 to 110 mg/dL increased from 38.9% to 50.4% (P < .001). The percentage of BG values less than 70 increased from 2.7% to 3.4% (P < .001). However, the percentage of severe hypoglyce-mic episodes (≤ 40 mg/dL) remained unchanged.
  
  
  CONCLUSIONS
  Access to real-time aggregated BG data reports through the use of a data management software program improved the efficacy of our TGC program.
authors.affiliation: University Health System, Medical Drive, San Antonio, TX 78229, USA. charles.reed@uhs-sa.com
authors.forename: Charles C
authors.initials: CC
authors.lastname: Reed
authors.forename: Jacqueline M
authors.initials: JM
authors.lastname: Richa
authors.forename: Andrea E
authors.initials: AE
authors.lastname: Berndt
authors.forename: Randy D
authors.initials: RD
authors.lastname: Beadle
authors.forename: Susan D
authors.initials: SD
authors.lastname: Gerhardt
authors.forename: Ronald
authors.initials: R
authors.lastname: Stewart
authors.forename: Michael
authors.initials: M
authors.lastname: Corneille
mesh_terms: D000328:Adult; D000465:Algorithms; D001786:Blood Glucose / Q000032:analysis*; D002984:Clinical Laboratory Information Systems; D003920:Diabetes Mellitus / Q000097:blood; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D010348:Patient Care Team / Q000458:organization & administration; D019095:Point-of-Care Systems; D058996:Quality Improvement; D012189:Retrospective Studies; D012984:Software
chemical_list: D001786:Blood Glucose