Assessing the Impact of an Order Panel Utilizing Weight-Based Insulin and Standardized Monitoring of Blood Glucose for Patients With Hyperkalemia
- Resource Type
- Authors
- Susan B. Freeman; Ted Shaikewitz; April A. Cooper; R. Clayton Musser; Tracy L. Setji; Rebecca Herbst; Noppon Setji; Sarah L. Hale; Kelby Brown; Beatrice D. Hong; Jimmy Greenlee
- Source
- American Journal of Medical Quality. 33:598-603
- Subject
- Blood Glucose
Male
Hyperkalemia
medicine.medical_treatment
Potassium
chemistry.chemical_element
030204 cardiovascular system & hematology
Hypoglycemia
Lower risk
03 medical and health sciences
0302 clinical medicine
medicine
Electronic Health Records
Humans
Insulin
In patient
030212 general & internal medicine
Aged
Retrospective Studies
Blood glucose monitoring
Medical Audit
medicine.diagnostic_test
business.industry
Health Policy
Body Weight
Middle Aged
medicine.disease
chemistry
Anesthesia
Administration, Intravenous
Female
medicine.symptom
business
Weight based dosing
- Language
- ISSN
- 1555-824X
1062-8606
Intravenous insulin with glucose is used in urgent treatment for hyperkalemia but has a significant risk of hypoglycemia. The authors developed an order panel within the electronic health record system that utilizes weight-based insulin dosing and standardized blood glucose monitoring to reduce hypoglycemia. As initial evaluation of this protocol, the authors retrospectively compared potassium and blood glucose lowering in patients treated with the weight-based (0.1 units/kg) insulin order panel (n = 195) with those given insulin based on provider judgment (n = 69). Serum potassium lowering did not differ between groups and there was no relationship between dose of insulin and amount of potassium lowering. There was a difference in hypoglycemia rates between groups ( P = .049), with fewer severe hypoglycemic events in the panel (2.56%) than in the non-panel group (10.14%). These data suggest weight-based insulin dosing is equally effective for lowering serum potassium and may lower risk of severe hypoglycemia.