Using electronic health records and clinical decision support to provide guidance on occupational factors which impact diabetes: a final knowledge resource report.

Details

• Personal Author:
  Allen A ; Baron, Sherry L. ; Bauer H ; Filios, Margaret S. ; Kirkland, Kimberly ; Marovich S ; Storey, Eileen ; Trout, Douglas B. ; Welch L
• Description:
  These recommendations are consistent with recommendations of the American Diabetes Association (ADAssn) and the quality measures used are from the National Quality Forum (NQF). Clinical Decision Support (CDS) was recommended only for patients where the HbA1c >/= 8 or reported episodes of hypoglycemia. While several reviewers noted that an HbA1c >/= 8 is not the ideal, based on discussions with primary care providers (PCP) it was determined that this would enable PCP to direct their efforts to patients most in need of education. This level can be altered based on a clinic's specific needs and population. We could not find a guideline that specifically addresses management of diabetes during shift work. In response to comments by reviewers, we acknowledge that we were unable to find any other instance of CDS like the one recommended being used in the primary care setting. The guidance provided here is based on understanding of factors that raise or lower blood sugar and that impact a person's use of insulin, such as physically demanding work, circumstances that increase cortisone output, or lack of food during periods of low blood sugar. We utilized what we know about factors present at work to provide guidance for management of a patient with diabetes working in those environments. The overall clinical objectives: a. Improve the management of diabetes when a patient has workplace factors such as shift work, temperature extremes, exertion variances and time limitations (for medication and proper meals) that can affect blood sugar. b. Understand how impairment of physical or mental function due to hypoglycemia may impact patient or public safety. c. Provide what guidance exists for work restrictions for individuals with diabetes.
• Subjects:
  Accidents, Occupational Air Pollutants, Occupational Air Pollution, Indoor Dust Manufacturing And Industrial Facilities Metal Workers Occupational Health Particulate Matter Preceptorship Safety Staff Development Surveys And Questionnaires Workplace

  More +
• Keywords:
  Blood Sugar Disorders Decision Making Diagnostic Techniques Electronic Health Records Guidelines Health Care Information Systems Recommendations
• Publisher:
  National Institute for Occupational Safety and Health
• Document Type:
  Text
• Funding:
  Contract
• Genre:
  Final Contract Report
• Place as Subject:
  District of Columbia ; Maryland ; New York ; Ohio ; OSHA Region 2 ; OSHA Region 3 ; OSHA Region 5 ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  DRDS - Division of Respiratory Disease Studies ; DSHEFS - Division of Surveillance, Hazard Evaluations, and Field Studies
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  1-30
• NIOSHTIC Number:
  nn:20052165
• Citation:
  Morgantown, WV: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Contract 212-2014-M-59011, 2015 Dec; :1-30
• Federal Fiscal Year:
  2016
• Performing Organization:
  Association of Occupational and Environmental
• Peer Reviewed:
  False
• Source Full Name:
  National Institute for Occupational Safety and Health
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:7d67db9d5ea771df03a5cd68c7bca59dd4bd87b9dc8d3ee356ca9b7711fad50e015e7c72b8dde16f9fda33a807597bd54a0081f3bb19ec02a2386e65ae862957
• Download URL:
  https://stacks.cdc.gov/view/cdc/181728/cdc_181728_DS1.pdf
• File Type:
  [PDF - 730.91 KB ]