Effectiveness of Surveillance System in Prevention of Hospital Hypoglycemia.

Abstract

Effectiveness of Surveillance System in Prevention of Hospital Hypoglycemia.

Swangjit                Sura-amornkul          MD, FRCP(T), MSc

Petcharaphan     Tiyamani                      BSc

Petch                     Rawdaree                    MD, FRCP(T), MSc

Endocrinology unit, department of medicine, Bangkok Metropolitan Administration Medical College and Vajira Hospital.

Objective: To reduce incidence and clinical impact of hospital hypoglycemia in diabetic patients at medicine ward.

Study design: A prospective interventional study.

Setting: Department of Medicine, Bangkok Metropolitan Administration Medical College and Vajira Hospital.

Subjects: 1,233 diabetic patients admitted in department of medicine from January to December 2004.

Intervention: The surveillance of hospital hypoglycemia had been implemented from January to December 2004 by multidisciplinary team.

Main outcome measures: Comparison the incidence of hospital hypoglycemia before and after surveillance indicated by

1.       rate of hospital hypoglycemia per all diabetic patients

2.       rate of hospital hypoglycemia per high risk diabetic patients

3.       level of clinical impacts of hospital hypoglycemia.

Results: Incidence of hospital hypoglycemia per all diabetic patients reduced after the surveillance of hospital hypoglycemia by multidisciplinary team from 5.01% to 4.28%. As well as incidence of hospital hypoglycemia per high risk diabetic patients decreased from 19.08% to 11.74% with relative risk reduction 38.5% after the surveillance. Less severity of clinical impacts of hospital hypoglycemia also demonstrated.

Conclusion: This study is a part of hospital accreditation process, clinical risk management. Hospital hypoglycemia in diabetic patients is the priority watch list of incident reports. The surveillance of hospital hypoglycemia by multidisciplinary team decreased rate of hospital hypoglycemia and severity of clinical impact.

Key words: hospital hypoglycemia, diabetes, root cause analysis, clinical risk, surveillance, multidisciplinary

Vajira Med J 2005 ; 49 : 59 - 67