We programmed a SQIA in the EMR. It requires the nurse to enter current glucose in the MAR, and then the calculated dose is shown. New dose is based on previous dose, and current and previous glucoses. The SQIA titrates the glucose to 120 -180 mg/dl for patients who are NPO, on TPN or Enteral Feedings (TF). No new orders are required even if insulin is added to TPN, or changes made in TF rates. Glucose and insulin data are shown in the table. The higher glucoses were at titration initiation. Two examples of how the titration worked are shown. Individual data demonstrate ability of the SQIA to titrate insulin and maintain glucoses in range despite significant changes to the rate of TF or addition of basal insulin as shown in Patient B. An automated SQIA allows insulin doses to be adjusted to the individual patient’s needs and maintain glucoses in range.


R.J. Rushakoff: None. E. Rov-Ikpah: None. C. San Luis: None. C. Johnson: None. S. Patzek: None. V. Juttukonda: None. H.W. Macmaster: None.

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