title: Substantial reduction in hospital stay of children and adolescents with diabetic ketoacidosis after implementation of Clinical Practice Guidelines in a university hospital in Saudi Arabia.
abstract: OBJECTIVE
  We aimed to determine the effect of Clinical Practice Guideline (CPG) implementation on length of hospital stay of children and adolescents with diabetic ketoacidosis (DKA).
  
  
  METHODS
  This was a 6-year (2008-2014) case-control retrospective study conducted at King Khalid University Hospital, Riyadh, that compared patients with DKA managed using CPG with those treated before CPG implementation.
  
  
  RESULTS
  There were 63 episodes of DKA in 41 patients managed using CPG compared with 40 episodes in 33 patients treated before implementation of CPG. Baseline characteristics of the 2 groups were similar (age, sex, newly diagnosed patients, recurrent DKA, DKA severity, and mean glycosylated hemoglobin). The mean length of hospital stay (±SD) was 68.6 ± 53.1 hours after implementation of CPG compared with 107.4 ± 65.6 hours before implementation (P < .001). The reduction in length of hospital stay equals to 1700 bed days saved per year per 1000 patients.
  
  
  CONCLUSIONS
  Implementation of CPG for DKA decreased the length of hospital stay.
authors.affiliation: Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Abdulrahman
authors.initials: A
authors.lastname: Al Nemri
authors.affiliation: Quality Management, King Khalid University Hospital, Riyadh, Saudi Arabia.|CPGs Steering Committee, King Saud University Medical City, Riyadh, Saudi Arabia.
authors.forename: Yasser Sami
authors.initials: YS
authors.lastname: Amer
authors.affiliation: Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Hala
authors.initials: H
authors.lastname: Gasim
authors.affiliation: Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Mohamed Elfaki
authors.initials: ME
authors.lastname: Osman
authors.affiliation: Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Ayman
authors.initials: A
authors.lastname: Aleyadhy
authors.affiliation: Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Hessah
authors.initials: H
authors.lastname: Al Otaibi
authors.affiliation: Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Shaikh Mohammed
authors.initials: SM
authors.lastname: Iqbal
authors.affiliation: Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Nasir Abdullah
authors.initials: NA
authors.lastname: Aljurayyan
authors.affiliation: Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia.|Prince Abdullah bin Khalid Coeliac Disease Research Chair, King Saud University College of Medicine, Riyadh, Saudi Arabia.
authors.forename: Asaad M
authors.initials: AM
authors.lastname: Assiri
authors.affiliation: Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia.|Department of Pediatrics, National Guard Hospital, Riyadh, Saudi Arabia.
authors.forename: Amir
authors.initials: A
authors.lastname: Babiker
authors.affiliation: Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia.|Department of Pediatrics, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
authors.forename: Sarar
authors.initials: S
authors.lastname: Mohamed
mesh_terms: D000293:Adolescent; D002648:Child; D016883:Diabetic Ketoacidosis / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin; D019983:Guideline Adherence; D006785:Hospitals, University / Q000592:standards*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D012529:Saudi Arabia; D012720:Severity of Illness Index
chemical_list: D006442:Glycated Hemoglobin
keywords: clinical audit; clinical guidelines; healthcare