Nurse-Directed Blood Glucose Management in a Medical Intensive Care Unit.
Crit Care Nurse
; 37(3): 30-40, 2017 Jun.
Article
en En
| MEDLINE
| ID: mdl-28572099
ABSTRACT
BACKGROUND:
Insulin-delivery algorithms for achieving glycemic control in the intensive care unit require frequent checks of blood glucose level and thus increase nursing workload. Hypoglycemia is a serious complication associated with intensive insulin therapy.OBJECTIVES:
To evaluate a nurse-directed protocol for blood glucose management that allows individualized insulin delivery within a predefined blood glucose corridor, intended to avoid hypoglycemia while maintaining adequate control of blood glucose level without increasing nursing workload.METHODS:
A nurse-directed protocol for blood glucose management was developed by an interprofessional team, and the protocol's performance was investigated in 175 patients compared with 384 historical controls.RESULTS:
With the nurse-directed protocol, hypoglycemia incidents declined significantly (31% vs 12%, P < .001), and minimum blood glucose levels increased significantly (80 mg/dL vs 93 mg/dL, P < .001). Mean and maximum blood glucose levels, the proportion of glucose readings within the target range (31% vs 26%, P = .06), and the number of blood glucose checks (59 vs 58, P = .85) remained unchanged with use of the protocol.CONCLUSION:
Implementation of the nurse-directed protocol for blood glucose management did not increase nursing workload but reduced hypoglycemia incidents significantly while maintaining adequate glycemic control.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Glucemia
/
Guías de Práctica Clínica como Asunto
/
Enfermería de Cuidados Críticos
/
Hiperglucemia
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Hipoglucemia
/
Hipoglucemiantes
/
Insulina
Tipo de estudio:
Guideline
Límite:
Adult
/
Aged
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Aged80
/
Female
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Humans
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Male
/
Middle aged
Idioma:
En
Año:
2017
Tipo del documento:
Article