%0 Journal Article
%T Development and Implementation of a Subcutaneous Insulin Clinical Decision Support Tool for Hospitalized Patients
%A Amy Knight
%A Annette Perschke
%A Christina Yuan
%A Estelle Everett
%A Gerald Godwin
%A Nestoras Mathioudakis
%A Peter Greene
%A Rebecca Jeun
%A Sherita Hill Golden
%A Swaytha Yalamanchi
%J Journal of Diabetes Science and Technology
%@ 1932-2968
%D 2019
%R 10.1177/1932296818798036
%X Insulin is one of the highest risk medications used in hospitalized patients. Multiple complex factors must be considered in determining a safe and effective insulin regimen. We sought to develop a computerized clinical decision support (CDS) tool to assist hospital-based clinicians in insulin management. Adapting existing clinical practice guidelines for inpatient glucose management, a design team selected, configured, and implemented a CDS tool to guide subcutaneous insulin dosing in non¨Ccritically ill hospitalized patients at two academic medical centers that use the EpicCare£¿ electronic medical record (EMR). The Agency for Healthcare Research and Quality (AHRQ) best practices in CDS design and implementation were followed. A CDS tool was developed in the form of an EpicCare SmartForm, which generates an insulin regimen by integrating information about the patient¡¯s body weight, diabetes type, home and hospital insulin requirements, and nutritional status. Total daily recommended insulin doses are distributed into respective basal and nutritional doses with a tailored correctional insulin scale. Preimplementation, several approaches were used to communicate this new tool to clinicians, including emails, lectures, and videos. Postimplementation, a support team was available to address user technical issues. Feedback from stakeholders has been used to continuously refine the tool. Inclusion of the programming in the EMR vendor¡¯s community library has allowed dissemination of the tool outside our institution. We have developed an EMR-based tool to guide SQ insulin dosing in non¨Ccritically ill hospitalized patients. Further studies are needed to evaluate adoption and clinical effectiveness of this intervention
%K clinical decision support systems
%K diabetes mellitus
%K hospital management insulin
%K subcutaneous (SQ)
%U https://journals.sagepub.com/doi/full/10.1177/1932296818798036