2011 QUALITY IMPROVEMENT INITIATIVES
Clinical Improvement Project:
Implementation of an integrated glucometer by Abbott diabetes care for the purpose of enhanced bedside glucose monitoring.
1. Design, Training, and Testing: November 2011-June 2012
In order to improve patient safety and patient care outcomes in the diabetic patient population new glucometers were needed for bedside glucose testing. The current industry standard for this type of testing includes the use of technology designed to identify the patient, the strip lot number, and the employee performing the test. The device is able to scan bar codes on the patient’s wrist band, scan the reagent strips to assure a current product, and scan the employee’s ID to assure accountability in resulting. This information is then uploaded directly to the electronic health record and makes the result available once the device has been docked in a designated docking station. In addition to these patient safety features the system is able to track staff competency, device functionality, and has advanced data reporting capabilities. Software associated with the glucometer will track when an employee needs to be retrained and will not let them use the device until they satisfy this requirement, it will track all quality measures that are performed daily to assure device accuracy, and it will historically log results that are unit and patient specific. Turning this information into retrievable discrete data allows the clinical management staff the ability to run periodic reports and monitor the quality of patient care delivered at the bedside. In addition, the advanced features of this system allows for insight into how we are caring for the diabetic patient population over time while offering the opportunity to improve the care we deliver based on this data.
Grace Cottage Hospital is a critical access facility with a three bed emergency room and a 19 bed inpatient unit caring for skilled nursing patients and the acutely ill. According to the United States Department of Health and Human Services “diabetes affects 25.8 million people of all ages” comprising “8.3 percent of the U.S. population”. Due to the prevalence of diabetes in America, organizations need to prioritize maintenance of the most current and safe patient care practices within this population. For this reason, the clinical staff at Grace Cottage determined the need to upgrade our existing bedside glucose testing devices to those that offer state of the art patient safety features found in more modern technology. The existing system did not offer any reporting capabilities nor did it store information centrally. In addition, patient and employee identification at the bedside was not a built in mandatory feature, it did not have bar code scanning capabilities, nor did it integrate directly with our electronic medical record. All of these missing features increased the possibility of misidentifying a patient, entering the data into the wrong chart, potentially administering the wrong dose of insulin, created challenges in assuring staff competency, and prevented the ability to establish clinical trends for the purpose of patient care improvement.
Prior to June 4th:
Post June 4th: