2013 myresearch Science Internship Program for Nursing

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3 2013 myresearch Science Internship Program for Nursing

4 Tamarea Townes Science Internship Program for Nursing

5 An Investigation of Risk Factors Associated with Hypoglycemia in Adult Hospitalized Patients Tamarea Townes Mary Chism, RN, BSN, MEd, CDE

6 Abstract This study investigated risk factors associated with hypoglycemia in adult hospitalized patients. Risk factors were investigated using electronic medical records. It was found that most patients that had coronary artery disease and hypertension and congestive heart failure were diagnosed with hypoglycemia.

7 Background Hypoglycemia is a medical condition in which the level of blood sugar falls dangerously below 70mg/dl. When there is too much insulin in the blood stream it can cause an unsafe drop in blood sugar or, hypoglycemia.

8 Background Hypoglycemia can be caused by eating meals too late or skipping a meal being more active than usual taking too much medicine having an alcoholic beverage without eating Most patients that have diabetes are given an insulin drip into their IV s when they are admitted into the hospital.

9 Background Side Effects Weakness or shaking, clammy or sweaty skin, increased heart rate, dizziness, sudden increased hunger, confusion, unsteadiness, nightmare or restless sleep, pale skin, irritability or numbness in mouth/tongue.

10 Problem Everyday more and more hospitalized patients are developing hypoglycemia. Physicians have been seeing more and more cases of this in their patients after they are admitted into the hospital.

11 Hypothesis Patients are given an insulin drip even though they have already previously taken their pre-assigned diabetes medications to lower their blood sugar. The insulin drip and their pre-assigned medications added together result in too much insulin in the blood stream and an unsafe drop in their blood sugars.

12 Methodology Everyday when patients were admitted into the hospital their demographics, (age, race, Hemoglobin A1c, Body Mass Index), medications list, and other problems where looked at.

13 Methodology Co morbidities such as: Renal insufficiency, Renal Failure, Myocardial infarct, Coronary Artery Disease, Hypertension, Congestive Heart Failure, Dementia or Any other documented compromised cognitive ability

14 Data Co Morbidities # of Subjects Renal Insufficiency 2 Renal Failure 2 Myocardial Infarct 3 Coronary Artery Disease 15 Hypertension 25 Congestive Heart Failure 7 Dementia 1 Other 5

15 Data RI RF MI CAD HTN CHF Dem. Other

16 Results Renal insufficiency: 5% Renal Failure: 5% Myocardial infarct: 8.3% Coronary Artery Disease: 41.6% Hypertension:69% Congestive Heart Failure:19.4% Dementia:2.7% Any other documented compromised cognitive ability:13.8%

17 Results 13 out of 25 patients that had Hypertension also had Coronary Artery Disease (52%) 5 out of 7 patients that had Congestive Heart Failure also had Coronary Artery Disease. (71%)

18 Conclusions Although there was not enough information to prove the hypothesis true, other conclusions were drawn from the data gathered: Patients that have both Coronary Artery Disease and Hypertension are at a high risk of developing hypoglycemia in a hospital. Patients that have both Congestive Heart Failure and Coronary Artery Disease are also at a high risk of developing hypoglycemia. Patients that have hypertension are at a high risk of hypoglycemia.

19 Recommendations This data is not completely accurate due to the small number of test subjects. A larger, much longer and more thorough research project would need to be conducted in order to provide more accurate data.

20 References. (n.d.). Retrieved July 19, 2013, from American Diabetes Association website: (n.d.). Retrieved July 19, 2013, from Ehow website: Hypoglycemia. (n.d.). Retrieved July 19, 2013, from National Diabetes Information Clearinghouse website: The Hypoglycemia Foundation. (n.d.). Retrieved July 19, 2013, from Hypoglycemia website:

21 Special Thanks Gail Hufgard, RN, CDE Mary Chism, RN, BSN, MEd, CDE Nancy Albert, PhD, RN Cheryl Baker, RE, LD, CDE Rosalind Strickland, Senior Director, Office of Civic Education Initiatives Nedra Starling, MPH, ABD, Manager, Instructional Design, Office of Civic Education Initiatives And Cleveland Clinic for this wonderful opportunity.

22 Copyright 2013 Cleveland Clinic Foundation

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