Effectiveness of standardised preoperative assessment and patient instructions on admission blood glucose for patients with diabetes undergoing orthopaedic surgery at a tertiary referral hospital

BMJ Open Qual. 2019 May 23;8(2):e000455. doi: 10.1136/bmjoq-2018-000455. eCollection 2019.

Abstract

Diabetes and hyperglycaemia affect a significant number of people and are associated with a variety of untoward effects, especially under physiological stress such as surgery. Due, in large part to limited evidence, clinical practice in monitoring blood glucose and treating hyperglycaemic conditions in the perioperative period is variable. We used Lean methodologies to implement a standardised approach to preoperative management of patients undergoing elective surgery in an effort to improve glycaemic control. Overall, we saw an appropriate increase in monitoring and a decrease in the rate of hyperglycaemia on presentation to the operating room. This approach may be useful in other care settings or patient populations, potentially contributing to improved glycaemic control and subsequent decrease in associated complications.

Keywords: diabetes mellitus; lean management; prehospital care; surgery.

MeSH terms

  • Aged
  • Blood Glucose / analysis*
  • Diabetes Mellitus / blood
  • Diabetes Mellitus / psychology
  • Diabetes Mellitus / therapy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Orthopedic Procedures / methods
  • Patient Admission
  • Patient Education as Topic / methods
  • Patient Education as Topic / standards*
  • Patient Education as Topic / statistics & numerical data
  • Preoperative Care / methods
  • Preoperative Care / standards
  • Preoperative Care / statistics & numerical data
  • Reference Standards*
  • Tertiary Care Centers / organization & administration
  • Tertiary Care Centers / statistics & numerical data

Substances

  • Blood Glucose