Using a Collaborative Interdisciplinary Team to Implement and Evaluate a Hyperglycemic Protocol from Admission to Discharge in the Cardiac Surgery Patient

2.50
Hdl Handle:
http://hdl.handle.net/10755/147172
Type:
Presentation
Title:
Using a Collaborative Interdisciplinary Team to Implement and Evaluate a Hyperglycemic Protocol from Admission to Discharge in the Cardiac Surgery Patient
Abstract:
Using a Collaborative Interdisciplinary Team to Implement and Evaluate a Hyperglycemic Protocol from Admission to Discharge in the Cardiac Surgery Patient
Conference Sponsor:Sigma Theta Tau International
Conference Year:2007
Author:Gallant, Paulette, RN, BSN
P.I. Institution Name:Maine Medical Center
Title:staff nurse
[Clinical session research presentation] A continuous insulin infusion (CIII) protocol has been used for five years in the cardiac surgery population to reduce the risk of sternal wound infections. However, this protocol had never been evaluated for level of reduction of glucose levels and adherence by the caregivers. A retrospective chart review of all glucose levels in 157 and 155 patients in two consecutive  studies revealed  alarming high glucose levels,  non-adherence in the use of the CIII protocol and a 3% sternal wound infection rate. In addition, the CIII was inconsistently discontinued in diabetic and non - diabetic patients resulting in confusion and frustration with the patients, nurses, and physicians. Consequently, a team consisting of physicians, physician assistants, staff nurses, clinical nurse specialists, dieticians, doctoral students and perfusionists met weekly to develop a systematic, evidence - based approach for treating hyperglycemia from admission to discharge in the cardiac surgery patient. This resulted in the development of a CIII nomogram based on the results of the retrospective chart review of the first two studies, revision of  the post-op cardiac surgery diet, pre-operative assessment of the hemoglobin A1C, a transition protocol on post-operative day three from CIII to correctional coverage and a discharge plan for glycemic control. Also, the quarterly sternal wound infection rate decreased to  1.5%. The third study is now in completion to further evaluate the effectiveness of the CIII. In conclusion this collaborative interdisciplinary team approach is being utilized to develop evidence-based systematic protocols to reduce blood stream infections and ventilator related pneumonia in the cardiac surgery population.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleUsing a Collaborative Interdisciplinary Team to Implement and Evaluate a Hyperglycemic Protocol from Admission to Discharge in the Cardiac Surgery Patienten_GB
dc.identifier.urihttp://hdl.handle.net/10755/147172-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Using a Collaborative Interdisciplinary Team to Implement and Evaluate a Hyperglycemic Protocol from Admission to Discharge in the Cardiac Surgery Patient</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2007</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Gallant, Paulette, RN, BSN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Maine Medical Center</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">staff nurse</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">gallap@mmc.org</td></tr><tr><td colspan="2" class="item-abstract">[Clinical session research presentation] A continuous insulin infusion (CIII)&nbsp;protocol has been used for five years in the cardiac surgery population to reduce the risk of sternal wound infections. However, this protocol had never been evaluated for level of reduction of glucose levels and adherence by the caregivers. A retrospective chart review of all glucose levels in&nbsp;157&nbsp;and 155&nbsp;patients in two consecutive&nbsp; studies revealed &nbsp;alarming high glucose levels,&nbsp; non-adherence&nbsp;in the use of the CIII protocol and a 3% sternal wound infection rate.&nbsp;In addition, the CIII was inconsistently discontinued&nbsp;in diabetic and non - diabetic patients resulting in confusion and frustration with the patients, nurses, and physicians. Consequently, a team consisting of physicians, physician assistants, staff nurses, clinical nurse specialists, dieticians, doctoral students and perfusionists met weekly to develop a systematic, evidence - based approach for treating hyperglycemia from admission to discharge in the cardiac surgery patient.&nbsp;This resulted in the development of a CIII nomogram based on the results of the retrospective chart review of the first two studies, revision of&nbsp; the post-op cardiac surgery diet, pre-operative assessment of the hemoglobin A1C, a transition protocol&nbsp;on post-operative day three from CIII&nbsp;to correctional coverage and a discharge plan for glycemic control. Also, the quarterly sternal wound infection rate decreased to&nbsp; 1.5%. The third study is now in completion to further evaluate the effectiveness of the CIII.&nbsp;In conclusion this collaborative interdisciplinary team approach is being utilized to develop evidence-based systematic protocols to reduce&nbsp;blood stream infections and ventilator related pneumonia in the&nbsp;cardiac surgery population.</td></tr></table>en_GB
dc.date.available2011-10-26T09:29:52Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T09:29:52Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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