Glycemic Monitoring and Control
The need to manage blood glucose levels is common among patients served in emergency, acute care, critical care and peri-operative settings. A number of tools have been developed to facilitate improved glycemic control for inpatients. These divide into those that facilitate surveillance and others that facilitate intervention. All are available when an inpatient chart is opened in the clinical information system (CIS).
Two tools help appreciate inpatients’ blood glucose response to problems and interventions: 1) an overview snapshot block, and 2) a glucose management summary. Both are part of the “Summary” section of an inpatient chart.
Another set of tools allows blood glucose monitoring data from patient observations and/or devices to be reviewed and incorporated into the Connect Care chart.
Patients can use the MyAHS Connect patient portal to enter their own capillary blood glucose measurements. They can transcribe data from a personal glucometer. In some cases, personal glucometers that integrate with SmartPhone apps can share data with Connect Care via standard interfaces (Apple Health for iPhones and iPads).
In order for this functionality to be available to patients, a few requirements must be met:
must have an active MyAHS Connect account, having followed instructions for activating the patient portal after securing an Alberta digital identity.
must "order" an appropriate patient portal flowsheet for a patient who will enter or interface blood glucose information.
Connect Care supports the Basal Bolus Insulin Therapy (BBIT) protocol to help clinicians determine patients’ insulin requirements and the optimal types and timings of insulin administration.
A good place to get oriented to Connect Care insulin management is through the BBIT navigator, even though this is typically used as part of an insulin ordering sequence. Thereafter, the process for completing BBIT orders and taking advantage of embedded decision supports makes more sense.