Perioperative Glucose Management in Orthopedic Surgery
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Abstract
Background: There is a definitive correlation between perioperative hyperglycemia and negative outcomes in orthopedic surgeries. Vigilant treatment of hyperglycemia (>180 mg/dL) will prevent negative outcomes such as joint failure, infection and pseudarthrosis. Local Problem: A Clinical Practice Guideline (CPG) focusing on the management of perioperative hyperglycemia for patients undergoing orthopedic surgery was created for a community hospital in Southern Maryland. Interventions: Data was collected using the following instruments: Practitioner Feedback Questionnaire (PFQ) and the Appraisal of Guidelines Research and Evaluation II Tool (AGREE II). The acceptance and usability of the clinical practice guideline (CPG) was evaluated through these instruments. Results: The dissemination and collection of the practitioner feedback survey resulted in a 100% response (N=16). The literature search was complete and relevant and the recommendations of the CPG were clear and suitable for the intended patient population. 90% of the clinician’s scores suggested they would feel comfortable utilizing the care model suggested in the CPG. Clinical expertise and demographic variables influenced the responses in the PFQ and Agree II tool. Conclusions: Overall the data collected demonstrated widespread acceptance and approval of this clinical practice guideline.