Care Gaps in the Administration of Prandial Insulin for Medical Inpatients
Bibliographic record
Abstract
Background Inpatient hyperglycemia is associated with multiple adverse outcomes. Lack of coordination between mealtimes and insulin delivery can worsen glycemic control. Logistical challenges at a systems level effecting the timing of insulin administration have not been examined. Local Problem Previous research identified difficulties coordinating prandial insulin delivery with mealtimes as a barrier to in-hospital euglycemia. Aim Characterize the process of prandial insulin delivery to identify care gaps. Methods Process mapping was used to describe the prandial insulin delivery on a medical inpatient unit. Nurses were surveyed to identify perceived barriers to insulin delivery. Results Short-acting insulins, which should be administered 30 minutes prior to meals, were consistently administered at incorrect times. Concerns of hypoglycemia and unpredictable meal delivery times were key nursing-identified barriers to insulin administration, which were discordant from findings observed. Conclusions Environmental and system factors on the inpatient medical units contribute to delayed administration of prandial short-acting insulin.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.024 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".