Does the use of a colour coded inpatient capillary blood glucose monitoring chart influence outcomes?

Authors

  • Dhiraj Sharma 1. Brighton and Sussex Medical School, Brighton, East Sussex, UK
  • Matthew Gerlach 2. Department of Medicine, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich, Norfolk, UK NR4 7UY
  • Vivek Sharma 3. Cambridge University Medical School, Cambridge, UK
  • Ketan Dhatariya Elsie Bertram Diabetes Centre, Norfolk and Norwich University Hospital NHS Foundation Trust, Colney Lane, Norwich, Norfolk, NR4 7UY

DOI:

https://doi.org/10.15277/bjd.2019.210

Keywords:

diabetes, inpatient, glucose chart, outcomes

Abstract

Background: Dysglycaemia in hospital inpatients is associated with harm. However, bedside capillary glucose monitoring often occurs with inadequate frequency, with inappropriate action taken when dysglycaemia occurs.

Aims: To assess whether the introduction of a colour coded blood glucose monitoring chart had an impact on glycaemic control, documentation of action taken, length of stay and mortality in an unselected cohort of hospital inpatients.

Methods: A cross-sectional study before (2014) and after (2017) the introduction of the new chart was undertaken. Data were collected for the 24 hours prior to inclusion in the study.

Results: Data from 56 individuals were collected in 2014 and from 161 in 2017. 57% and 22% experienced dysglycaemia in 2014 and 2017, respectively. Action was taken in 24.2% of cases in 2014 and in 56.8% in 2017. Median length of stay was 16.1 days (IQR 8.4–39.4) in 2014 and 13.1 days (5.7–25.3) in 2017. For those who experienced dysglycaemia and in whom action was not recorded, mortality was 30% and 20% in 2014 and 2017 compared with 6% and 15%, respectively, for those who had no dysglycaemia.

Conclusions: The introduction of a colour coded blood glucose monitoring chart led to more action being recorded when dysglycaemia occurred and reduced length of hospital stay and mortality.

Author Biographies

Dhiraj Sharma, 1. Brighton and Sussex Medical School, Brighton, East Sussex, UK

Medical student at Brighton and Sussex Medical School

Matthew Gerlach, 2. Department of Medicine, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich, Norfolk, UK NR4 7UY

FY1 at Department of Medicine, Norfolk and Norwich University Hospitals

Vivek Sharma, 3. Cambridge University Medical School, Cambridge, UK

Medical student at Cambridge University Medical School

Ketan Dhatariya, Elsie Bertram Diabetes Centre, Norfolk and Norwich University Hospital NHS Foundation Trust, Colney Lane, Norwich, Norfolk, NR4 7UY

Consultant in diabetes, endocrinology and general medicine

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Published

2019-06-27

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Original Research

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