| Title | An Electronic Protocol for Translation of Research Results to Clinical Practice: A Preliminary Report. | | Author(s) | Morris AH, Orme J, Rocha BH, Holmen J, Clemmer T, Nelson N, Allen J, Jephson A, Sorenson D, Sward K, Warner H, for the Reengineering Critical Care Clinical Research Investigators | | Institution | Pulmonary and Critical Care Divisions, Departments of Medicine, Intermountain Healthcare Urban Central Region and University of Utah School of Medicine , Salt Lake City, Utah. | | Source | J Diabetes Sci Technol 2008 Sep; 2(5):802-808. | | Abstract | INTRODUCTION: We evaluated the feasibility of using an electronic protocol developed for research use (Research-eProtocol-insulin) for blood glucose management in usual intensive care unit clinical practice.
METHODS: We implemented the rules of Research-eProtocol-insulin in the electronic medical record of the Intermountain Healthcare hospital system (Clinical-eProtocol-insulin) for use in usual clinical practice. We evaluated the performance of Clinical-eProtocol-insulin rules in the intensive care units of seven Intermountain Healthcare hospitals and compared this performance with the performance of Research-eProtocol-insulin at the LDS Hospital Shock/Trauma/Respiratory Intensive Care Unit.
RESULTS: Clinician (nurse or physician) compliance with computerized protocol recommendations was 95% (of 21,325 recommendations) with Research-eProtocol-insulin and 92% (of 109,458 recommendations) with Clinical-eProtocol-insulin. The blood glucose distribution in clinical practice (Clinical-eProtocol-insulin) was similar to the research use distribution (Research-eProtocol-insulin); however, the mean values (119 mg/dl vs 113 mg/dl) were statistically different (P = 0.0001). Hypoglycemia rates in the research and practice settings did not differ: the percentage of measurements </=40 mg/dl (0.11% vs 0.1%, P = 0.65) and the percentage of patients with at least one blood glucose </=40 mg/dl (4.2% vs 3%, P = 0.23) were not statistically significantly different.
CONCLUSION: Our electronic blood glucose protocol enabled translation of a research decision-support tool (Research-eProtocol-insulin) to usual clinical practice (Clinical-eProtocol-insulin). | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 19885263 |
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