SHM Converge Scientific Abstract ePoster Gallery-Minimizing Time to Glargine Administration During Transition From Iv Insulin in Icu Patients Quality Improvement Study

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This quality improvement study from the University of New Mexico examined whether moving glargine from central pharmacy to the ICU medication dispensing system could speed the transition from IV insulin to subcutaneous insulin in ICU patients with diabetic ketoacidosis (DKA).<br /><br />The project was motivated by delays in glargine administration, which were believed to prolong ICU length of stay and slow recovery. A multidisciplinary team of providers, nurses, pharmacy staff, and informatics specialists redesigned the process so ICU nurses could access glargine directly, rather than waiting for central pharmacy preparation and delivery.<br /><br />Researchers retrospectively reviewed 18 ICU DKA patients before and after the change. They measured time from glargine order to administration, time from IV insulin start to glargine administration, and rates of hypo- and hyperglycemia within five days after transition. Outliers were removed using box-and-whisker analysis.<br /><br />The results showed a significant improvement in administration speed: time from glargine order to administration decreased from 79.5 minutes to 43.2 minutes (p = 0.0001). The time from IV insulin start to glargine administration did not change significantly. Importantly, the intervention did not increase adverse glycemic events, with no significant rise in hypoglycemia or hyperglycemia.<br /><br />The study concludes that a relatively small systems change—relocating glargine to the ICU dispensing system—can meaningfully reduce delays without harming patient safety. The authors note that this could potentially help patients transfer out of the ICU sooner, though more research is needed. They also emphasize the importance of team-based collaboration and suggest future quality improvement cycles could focus on reducing overall time on IV insulin and optimizing glycemic control further.

Asset Subtitle

Noah M. Lucero

Meta Tag

Author List John Williams, Kendall Rogers, Noah M. Lucero

Category Research

Concept Diabetic Ketoacidosis

Concept Insulin

Concept Insulin Glargine

Concept Order-to-Administration Delay

Concept Time to Medication Administration

Distinguished Non-Finalist

Presenter Organization University of New Mexico School of Medicine

Presenting Author Noah M. Lucero

Track Quality Improvement

Keywords

glargine

diabetic ketoacidosis

ICU

insulin transition

quality improvement

medication dispensing system

hypoglycemia

hyperglycemia

pharmacy workflow

patient safety

Diabetic Ketoacidosis

Insulin

Insulin Glargine

Order-to-Administration Delay

Time to Medication Administration