Journal article
Hypoglycemia Adverse Events in PICUs and Cardiac ICUs: Differentiating Preventable and Nonpreventable Events
Pediatric critical care medicine, v 14(8), pp 741-746
01 Oct 2013
PMID: 23863820
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Objectives: To describe the use of an adverse event detection system to identify, characterize, and categorize preventable versus nonpreventable hypoglycemia AEs in PICUs and cardiac ICUs.
Design: Retrospective observational study.
Setting: PICU and cardiac ICU of a tertiary pediatric hospital.
Subjects: All hypoglycemia triggers generated over a 3-year period.
Interventions: All hypoglycemia triggers generated via an electronic health record-driven surveillance system were investigated to determine if they represented a true adverse event and if that event was preventable or nonpreventable. Clinical and demographic variables were analyzed to identify characteristics of patients who developed a preventable or nonpreventable hypoglycemia adverse event.
Measurements and Main Results: There were 197 hypoglycemia adverse events in 90 patients. Thirty percent of the adverse events in the PICU and 36% of the adverse events in the cardiac ICU were characterized as preventable. Of the adverse events, 118 (59.9%) necessitated an intravenous dextrose bolus. No adverse events were associated with reporting of symptoms of hypoglycemia including apnea, altered mental status, or seizures. Events were more likely to be preventable (p < 0.001) if the patient was receiving only parenteral sources of nutrition (intravenous fluids or total parenteral nutrition). Controlling for weekends and holidays, adverse events associated with sole parenteral nutrition source had an increased odds ratio of 9.5 (95% confidence interval: 2.8-31.9) of being preventable. Stratifying by ICU, cardiac ICU events occurring on a weekend or holiday were more likely to be preventable (p = 0.001). Stratifying by unit and controlling for parenteral nutrition source, adverse events in the cardiac ICU occurring on weekends or holidays had an increased odds ratio of 11.6 (95% confidence interval: 2.7-50.2) of being preventable.
Conclusions: Preventable hypoglycemia adverse events are associated with patients receiving sole parenteral sources of nutrition in both the PICU and cardiac ICU. In the cardiac ICU, there is an association between weekend and holiday time periods and the development of preventable hypoglycemia adverse events.
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Details
- Title
- Hypoglycemia Adverse Events in PICUs and Cardiac ICUs: Differentiating Preventable and Nonpreventable Events
- Creators
- Paul L. Shea - George Washington UniversityMichael C. Spaeder - Children’s National Health SystemPuneet Sayal - Harvard University ,Brian R. Jacobs - Children’s National Health SystemDavid C. Stockwell - Children’s National Health System
- Publication Details
- Pediatric critical care medicine, v 14(8), pp 741-746
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 6
- Grant note
- Cerner Corporation, Kansas City, MO Cerner Corporation
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pediatrics
- Web of Science ID
- WOS:000336518300007
- Scopus ID
- 2-s2.0-84885642972
- Other Identifier
- 991019167951804721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Critical Care Medicine
- Pediatrics