Hospital Guidelines for Diabetes Management and the Joint Commission-American Diabetes Association Inpatient Diabetes Certification.

Background: The Joint Commission Advanced Inpatient Diabetes Certification Program is founded on the American Diabetes Association's Clinical Practice Recommendations and is linked to the Joint Commission Standards. Diabetes currently affects 29.1 million people in the USA and another 86 million Americans are estimated to have pre-diabetes.

Evaluation of Ward Management of Diabetic Ketoacidosis.

Ward management of diabetic ketoacidosis (DKA) using subcutaneous insulin in specific patient populations is safe and effective, but insulin administered by continuous infusion has not been analyzed in this setting. This retrospective cohort study utilizing a nursing-driven, continuous infusion insulin calculator demonstrated safe and effective treatment of patients with DKA on medicine wards.

Impact of improvement efforts on glycemic control and hypoglycemia at a university medical center.

Background: Great emphasis is placed on optimizing treatment of hospitalized patients with diabetes and hyperglycemia.

Objective: This study was conducted to determine if the application of hospital-wide insulin order sets improved inpatient safety by reducing the number of actual hypoglycemic and hyperglycemic events and increasing at-target blood glucose.

Design: A retrospective chart review was conducted of hypoglycemic and hyperglycemic events and at-target blood glucose occurring before and after institution of the insulin order sets and blood glucose protocols.

Evaluation of hospital glycemic control at US academic medical centers.

Objective: To evaluate contemporary hospital glycemic management in US academic medical centers.

Design: This retrospective cohort study was conducted on patients discharged from 37 academic medical centers between July 1 and September 30, 2004; 1,718 eligible adult patients met at least 1 of the inclusion criteria: 2 consecutive blood glucose readings >180 mg/dL within 24 hours, or insulin treatment at any time during hospitalization. We assessed 3 consecutive measurement days of glucose values, glycemic therapy, and additional clinical and laboratory characteristics.

Improving hyperglycemia in the hospital: outcomes of a nursing in-service to evaluate acceptance of a web-based insulin infusion calculator.

Background: Many insulin infusion protocols are available for clinical use. We developed a Web-based, online intravenous insulin infusion calculator (IVIIC) for use in our intensive care and medical-surgical units.

Methods: In September 2006, we implemented a quality improvement project: an online survey to evaluate the acceptance of this protocol by the nursing staff.

Outcomes of a cardiothoracic intensive care web-based online intravenous insulin infusion calculator study at a Medical University Hospital.

Background: The purpose of this study was to examine whether a web-based, on-line intravenous insulin (IVI) infusion calculator (IVIIC) program for the delivery of IVI therapy in coronary artery bypass graft (CABG) patients was superior to a prior IVI protocol used in the cardiothoracic intensive care unit at our institution.

Methods: The study included 97 CABG patients studied from October 2004 to February 2005 pre-protocol (type 2 diabetes) and October 2005 to February 2006 post-protocol (with or without type 2 diabetes). The IVIIC was programmed to resemble an algorithm whereby any patient with type 2 diabetes or a blood glucose (BG) greater than 120 mg/dL was started on IVI with an insulin sensitivity factor, a multiplier of 0.

Evidence of homolytic and heterolytic pathways in the photodissociation of iminosulfonates and direct detection of the p-toluenesulfonyloxyl radical.

The mechanistic aspects of the photochemistry of several iminosulfonate photoacid generators (PAGs) have been studied based on product analysis, nanosecond laser flash photolysis, and determination of acid generation efficiencies. Our findings support a competition between homolytic and heterolytic N-O dissociation mechanisms. By measuring the efficiencies of acid generation for each PAG in the presence and absence of an ion quencher, we were able to roughly quantify the degree of branching between heterolytic and homolytic photocleavage pathways for each PAG.

CASE STUDIES for Dentistry: development of a tool to author interactive, multimedia, computer-based patient simulations.

Computer-based patient simulations have been used to enhance the dental curriculum since the 1980s. This article describes the development of CASE STUDIES for Dentistry (CSD), a patient case simulation building template, developed at Virginia Commonwealth University, with which authors who have no programming expertise can create realistic, effective, interactive multimedia patient simulations by entering their own information and images into a straightforward, fill in the blanks interface. This program was written with Authorware, by Macromedia Inc.