Improving Blood Glucose Control With a Computerized Decision Support Tool: Phase 1



Status:Recruiting
Conditions:Hospital, Diabetes
Therapuetic Areas:Endocrinology, Other
Healthy:No
Age Range:Any
Updated:4/2/2016
Start Date:February 2006
End Date:December 2018
Contact:Alan H Morris, MD
Email:Alan.Morris@intermountainmail.org
Phone:801-408-1610

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Clinical Process Improvement With A Bedside Computerized Insulin Therapy Protocol For Blood Glucose Control (eProtocol-insulin) in Adult And Pediatric ICU Patients:Further Refinement and Validation of eProtocol-insulin

The Purpose of this study is to:

1. Refine and validate a computerized bedside decision support tool blood glucose
management in critically ill adult and pediatric ICU patients.

2. Monitor how often low blood sugar levels occur during use of the bedside tool.

3. Determine how the computerized tool effects the workload of the ICU nurses.

This first phase will be a prospective cohort study. We will validate the bedside tool in at
least 4 adult and at least 4 pediatric ICUs and if necessary we will modify the bedside
tool. The computerized bedside tool will be considered refined if >90% of the generated
instructions are accepted and if the percent of glucose values in the 70-110 mg/dl range are
equivalent to our pilot experience rate of 55%, and if the rate of glucose values less than
or equal to 40 mg/dl is less than 0.5% of glucose measurements.

Inclusion Criteria:

1. Pediatric ICU: Proposed indications by pediatric clinicians at participating ICUs for
glucose control in their ICUs would include patients who require mechanical
ventilation for greater than 24 hours and/or require a vasoactive infusion (e.g.
dopamine >3 mg/kg/min, dobutamine, epinephrine, or vasopressin).

2. Adult ICUs: Proposed indications by clinicians in participating ICUs for glucose
control in participating adult ICUs include critically ill patients with an
anticipated ICU length of stay of 3 or more days.

Exclusion Criteria:

1. Pregnancy (negative pregnancy test required for females of child-bearing age)

2. Age less than one month

3. Inborn errors of metabolism that the clinician suspects will affect glucose
homeostasis

4. Acute or chronic liver disease with any documented episode of blood or plasma glucose
<60 mg/dl within the 24 hours prior to study entry

5. Diabetic Ketoacidosis (critically ill patients with insulin dependent diabetes not in
ketoacidosis will be eligible if attending physicians intend to use intravenous
insulin as part of ordinary care)

6. Severe chronic liver disease (Child-Pugh score >10)
We found this trial at
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sites
3400 N Charles St
Baltimore, Maryland 21205
410-516-8000
Johns Hopkins University The Johns Hopkins University opened in 1876, with the inauguration of its...
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185 Cambridge Street
Boston, Massachusetts 02114
617-724-5200
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South 34th Street
Philadelphia, Pennsylvania 19104
 215-590-1000
Children's Hospital of Philadelphia Since its start in 1855 as the nation's first hospital devoted...
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Charlottesville, Virginia 22903
(434) 924-0311
University of Virginia The University of Virginia is distinctive among institutions of higher education. Founded...
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Hersey, Pennsylvania 17033
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2201 West End Ave
Nashville, Tennessee 37232
(615) 322-7311
Vanderbilt University Vanderbilt offers undergraduate programs in the liberal arts and sciences, engineering, music, education...
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New Haven, Connecticut 6520
(203) 432-4771
Yale University Yale's roots can be traced back to the 1640s, when colonial clergymen led...
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Salt Lake City, Utah 84143
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8th Ave & C St
Salt Lake City, Utah 84143
(801) 408-1100
LDS Hospital LDS Hospital provides clinical excellence to our community in a wide range of...
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759 Chestnut Street
Springfield, Massachusetts 01199
(413) 794 - 0000
Baystate Medical Center Baystate Medical Center (BMC), in Springfield, Massachusetts, is an academic, research, and...
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Winston-Salem, North Carolina 27157
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