Improving glycemic control with the adjunct use of a data management software program

Background: Published studies have supported the implementation of tight glucose control (TGC) programs to improve patient outcomes and reduce mortality rates. However, measuring a program's efficiency is challenging, because of a lack of systems that capture data, allow access to data, and support analysis and interpretation in a near prospective time frame. We hypothesized that providing clinicians access to realtime blood glucose (BG) results reports could improve the efficacy of our TGC program. Methods: We performed a retrospective review of BG data during a 12-month period in a surgical trauma intensive care unit at a level I trauma center. A unit-specific insulin algorithm was used throughout the study. We compared BG values before and after the implementation of a data management software program that allowed clinicians access to real-time BG results reports. Reports were run daily and weekly to monitor the unit's TGC program. Results: A total of 70 616 BG values from 1044 patients were analyzed. An overall decrease was observed in the BG level mean, from 121 mg/dL to 112 mg/dL ( P < .001), as well as a decrease in the aggregated mean across patients, from 132 mg/dL to 119 mg/dL ( P < .001), after implementation of the software. The percentage of values within the target range of 80 to 110 mg/dL increased from 38.9% to 50.4% ( P < .001). The percentage of BG values less than 70 increased from 2.7% to 3.4% ( P < .001). However, the percentage of severe hypoglyce-mic episodes ( ≤ 40 mg/dL) remained unchanged. Conclusions: Access to real-time aggregated BG data reports through the use of a data management software program improved the efficacy of our TGC program.