Number and proportion of patients monitored and treated according to the hyperglycaemia (sugar) protocol
| Statewide aggregate | QASC trial | |||||
|---|---|---|---|---|---|---|
| Element | Monitoring and treatment | Preimplementation audit (n=1062) | Postimplementation audit (n=1082) | OR (95% CI) | p Value | Interventio n group (n=603) |
| Monitoring | ||||||
| M1 | Formal VBG measurement in the ED | 678 (64%) | 754 (70%) | 1.28 (0.83 to 1.97) | 0.27 | 184 (31%) |
| M2 | Finger-prick blood glucose level recorded at least four times on day 1 | 533 (50%) | 749 (69%) | 2.50 (1.66 to 3.75) | <0.0001 | 362 (60%) |
| M3 | Finger-prick blood glucose level recorded at least four times on day 2 | 442 (43%) | 679 (66%) | 2.81 (1.89 to 4.16) | <0.0001 | 314 (52%) |
| M4 | Finger-prick blood glucose level recorded at least four times on day 3 | 179 (60%) | 222 (79%) | 2.41 (1.54 to 3.78) | 0.0001 | 311 (52%) |
| Monitoring adherence* | ||||||
| Monitored according to the protocol for hyperglycaemia | 301 (28%) | 424 (39%) | 1.66 (1.11 to 2.48) | 0.014 | 61 (10%) | |
| Treatment | ||||||
| At least one finger-prick glucose level of >10 mmol/L | 187 (18%) | 205 (19%) | 1.11 (0.85 to 1.43) | 0.44 | 135 (22%) | |
| T1 | Insulin received within 1 h of their finger-prick glucose level of >10 mmol/L | 41 (22%) | 56 (27%) | 1.32 (0.79 to 2.21) | 0.30 | 19 (14%) |
| Protocol adherence: monitored and treated† | ||||||
| Monitored and treated according to the protocol for hyperglycaemia | 240 (23%) | 363 (34%) | 1.76 (1.16 to 2.69) | 0.0085 | 21 (3.5%) | |
Day 1 indicates first 24 h since admission to hospital. The protocol recommends that observations should be taken at least six hourly, so there should be at least four separate finger-prick blood glucose levels taken during the first 24 h of admission to hospital. Formal VBG defined as: blood glucose sample sent to laboratory for analysis.
Statistically significant p values are shown in bold.
*Must meet all M1, M2, M3 and M4 to be deemed as having been monitored according to protocol if the patient is known to have diabetes or is not known to have diabetes but has one or more episodes of hyperglycaemia (glucose >10 mmol/L). Must meet all M1, M2 and M3 and have no episode of hyperglycaemia (glucose>10 mmol/L) to be deemed as having been monitored according to protocol if the patient is not known to have diabetes.
†Must meet all M1, M2, M3 and M4 (if applicable, see*) and T1 to be deemed as having been monitored and treated according to protocol.
ED, emergency department; QASC, Quality in Acute Stroke Care; VBG, venous blood glucose.