CSEM

CSEM2404 - CSEM Resident Oral Abstract Presentations - Optimizing Point-of-Care Capillary Blood Glucose Utilization in Hospitalized Patients: A Quality Improvement Initiative

Thursday, November 21, 2024

14:32 - 14:39 AT Time

Location: Argyle A3

Submitting Author(s)

KM

Kyle Moxham, MD, BSc

Resident Physician
University of Alberta
Edmonton, Alberta, Canada

Disclosure(s): I do not have a relationship with a for-profit and/or a not-for-profit organization to disclose

Presenting Author(s)

KM

Kyle Moxham, MD, BSc

Resident Physician
University of Alberta
Edmonton, Alberta, Canada

Disclosure(s): I do not have a relationship with a for-profit and/or a not-for-profit organization to disclose

First Author(s)

KM

Kyle Moxham, MD, BSc

Resident Physician
University of Alberta
Edmonton, Alberta, Canada

Disclosure(s): I do not have a relationship with a for-profit and/or a not-for-profit organization to disclose

Co-Author(s)

PM

Pamela Mathura, PhD

University of Alberta, Canada

Disclosure information not submitted.
JV

Joseph Vong, n/a

Alberta Health Services, Edmonton Zone Medicine Program
Edmonton, Alberta, Canada

Disclosure information not submitted.
Darren Lau, AB (he/him/his)

Assistant Professor
University of Alberta
Edmonton, Alberta, Canada

Disclosure information not submitted.

Abstract: Hospitalized adults commonly have routine point-of-care capillary blood glucose testing (CBG) ordered on admission. Excessive CBG may strain nursing resources without notable patient benefits. This study’s objective was to reduce the frequency of unnecessary CBG in hospitalized General Internal Medicine (GIM) patients at the University of Alberta Hospital. Using the Model of Improvement with Plan-Do-Study-Act (PDSA) cycles, an evidence-based CBG rationalization algorithm was established and trialed (started in March 2024) using an educational approach targeting ordering physicians and nurses. A retrospective chart audit estimated baseline CBG utilization. The primary outcome measurement was the prevalence of patients with unnecessary CBG orders at the time of hospital discharge. Intervention impact was determined by chart audit. Descriptive statistics supported analysis. A total of 784 charts were reviewed pre- and post-intervention, with 84% (n = 655) of patients having CBG ordered on admission. The frequency of unnecessary CBG orders at discharge decreased from 28.2% (48/170) to 14.8% (72/485). The average length of stay until CBG de-escalation improved from 10.6 days to 6.7 days (difference: -3.9 days). Patients who underwent CBG de-escalation at day 3 of admission (if eligible) improved 19.3% from 20.4% (11/54) to 39.7% (58/146) post-intervention. The intervention was sustained following a 6 month follow up period. CBG measurements in-hospital are frequently unnecessary resulting in inefficient use of nursing resources. The absence of established algorithms for reassessing POCT frequency may perpetuate unnecessary testing during hospitalization.