Implementing a pharmacist consultation model for multimodal insulin therapy
| العنوان: | Implementing a pharmacist consultation model for multimodal insulin therapy |
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| المؤلفون: | Angela Hodges, Tammy Ellis, Esther Castellanos, Edward Laue, LaDonna Oelschlaeger, James Hall |
| المصدر: | American Journal of Health-System Pharmacy. 74:e224-e229 |
| بيانات النشر: | Oxford University Press (OUP), 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | Blood Glucose, medicine.medical_specialty, medicine.medical_treatment, Pharmacist, 030209 endocrinology & metabolism, Pharmacy, Pharmacists, Tertiary Care Centers, Order entry, 03 medical and health sciences, 0302 clinical medicine, Clinical Protocols, Diabetes mellitus, medicine, Humans, Hypoglycemic Agents, Insulin, 030212 general & internal medicine, Intensive care medicine, Referral and Consultation, Pharmacology, business.industry, Health Policy, Insulin dosage, Health Plan Implementation, medicine.disease, Hypoglycemia, Community hospital, Hospitalization, Glycemic management, Treatment Outcome, Diabetes Mellitus, Type 2, Hyperglycemia, Emergency medicine, Pharmacy Service, Hospital, business, Program Evaluation |
| الوصف: | Purpose The implementation of pharmacist-managed insulin dosing for selected hospitalized patients under a multimodal insulin protocol (MMIP) is described. Summary Hyperglycemia has been linked to increased thrombosis, decreased wound healing, and decreased immune response. Current recommendations support the use of multimodal (basal–bolus) insulin therapy in noncritically ill inpatients. As part of a systemwide quality-improvement initiative to improve glycemic management, the pharmacy department of a community hospital initiated a service to provide protocol-directed insulin dosing for selected patients under a pharmacist consultation model. An MMIP targeting patients with 2 blood glucose (BG) readings of >180 mg/dL within a 12-hour period was developed and approved. Pharmacist consultations, including patient assessment, entry of initial insulin orders, and ongoing insulin dosage adjustments, are performed pursuant to electronic notifications and computerized prescriber order entry. Noncritically ill patients who meet the criteria for protocol-guided insulin dosing are managed according to an approved weight-based MMIP for calculating and adjusting nutritional and basal insulin doses. Prior to the initiation of MMIP-guided insulin dosing, pharmacists were trained on the use of the protocol and passed a competency assessment. In the 90-day period after protocol implementation, 158 hyperglycemic patients received pharmacist-managed insulin dosing. Conclusion The goal of achieving a mean BG concentration of ≤180 mg/dL by day 3 of hyperglycemia management under a pharmacist-managed MMIP was attained in the second and third months after protocol implementation. |
| تدمد: | 1535-2900 1079-2082 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::1f24c698625a7aa8513c67cb834af5abTest https://doi.org/10.2146/ajhp150941Test |
| رقم الانضمام: | edsair.doi.dedup.....1f24c698625a7aa8513c67cb834af5ab |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15352900 10792082 |
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