Effect of an intervention on quality indicators for improving the treatment of hyperglycemia in patients hospitalized in noncritical areas.
OBJECTIVE
We evaluated the effect of an intervention on certain quality indicators employed for improving the treatment of hospital hyperglycemia.


METHODS
A multicenter cross-sectional study was conducted on patients with hyperglycemia hospitalized in the internal medicine departments of 44 hospitals evaluated in 2 time periods: 2014 (baseline period) and 2015 (postintervention period). The intervention consisted of the dissemination of the indicators obtained in 2014 and the objectives for improvement. As indicators, we assessed the frequency of glucose monitoring adapted to the patient's dietary intake or medication, the use of basal-bolus or basal-bolus-correction insulin therapy as the preferred control method of hyperglycemia and the recent availability of HbA1c prior to hospital discharge.


RESULTS
A total of 506 and 562 patients were assessed in 2014 and 2015, respectively. The results of the indicators in the baseline and postintervention periods were as follows: blood glucose monitoring adapted to the dietary intake or the medication (71.5 vs. 74.1%, P=.33), use of insulin in basal-correction regimen (32 vs. 32.6%, P=.61) or basal-bolo-correction (20.7 vs. 24, P=.20) and recent HbA1c value (54.1 vs. 66.3%, P<.001). The mean glucose values in the 24h prior to the study were similar in the 2 periods. The rate of hypoglycemia was also similar in both periods (3.3 vs. 2.3%, P=.31).


CONCLUSIONS
There is a need to implement multimodal interventions to improve the treatment of hyperglycemia in patients hospitalized in noncritical areas.
Departamento de Medicina Interna, Hospital Marina Baixa, Villajoyosa (Alicante), España. Electronic address: ena_jav@gva.es.
J
J
Ena
Departamento de Medicina Interna, Hospital Regional Universitario de Málaga, Málaga, España.
R
R
Gómez-Huelgas
Departamento de Medicina Interna, Hospital Universitario de Fuenlabrada, Madrid, España.
A
A
Zapatero-Gaviria
Departamento de Medicina Interna, Complejo Hospitalario A Coruña, La Coruña, España.
P
P
Vázquez-Rodriguez
Departamento de Medicina Interna, Hospital San Juan de Dios Aljarafe, Sevilla, España.
C
C
González-Becerra
Departamento de Medicina Interna, Hospital Universitario de Fuenlabrada, Madrid, España.
M
M
Romero-Sánchez
Departamento de Medicina Interna, Hospital Royo Villanova, Zaragoza, España.
M J
MJ
Igúzquiza-Pellejero
Departamento de Medicina Interna, Hospital Dr. Peset, Valencia, España.
A
A
Artero-Mora
Departamento de Medicina Interna, Hospital Virgen del Rocío, Sevilla, España.
J M
JM
Varela-Aguilar
Clinical practice guidelines; Diabetes mellitus; Guías de práctica clínica; Indicadores de calidad; Médicos; Physicians; Quality indicators