Translating Research into Practice: Glycemic Control of Critically Ill Patients

2.50
Hdl Handle:
http://hdl.handle.net/10755/154372
Type:
Presentation
Title:
Translating Research into Practice: Glycemic Control of Critically Ill Patients
Abstract:
Translating Research into Practice: Glycemic Control of Critically Ill Patients
Conference Sponsor:Sigma Theta Tau International
Conference Year:2006
Author:Sendelbach, Sue, RN, PhD, CCNS, FAHA
P.I. Institution Name:Abbott Northwestern Hospital
Title:Clinical Nurse Researcher
Co-Authors:Jessica M. Swearingen, PharmD, BCPS; Robert Miner, MD
Background: The benefits of tight glycemic control in critically ill patients have been well established in the literature and include decreases in mortality, organ dysfunction and length of stay.  Purpose: The purpose of this evidence based project was two-fold: 1) to standardize the IV intensive insulin protocol; and 2) to decrease the goal blood glucose range to values recommended by the American Society of Endocrinologists.  The study targeted patients who were both hyperglycemic and critically ill. Description: An interdisciplinary group, consisting of a clinical nurse specialist, a critical care pharmacist, staff nurses from the critical care units, an endocrinologist and hospitalist, convened to assess current blood glucose management, develop and implement an intensive insulin therapy protocol and evaluate the impact of the protocol on glycemic management in critically ill patients.  The primary objective was to achieve and maintain blood glucose levels between 90-120 mg/dL Due to the complexity of the protocol, a computer program was developed to aid nurses in calculating insulin dose changes and to decrease risk for error.  The protocol calculates insulin dose changes based on the patient?s last 2 blood glucose values.  The computerized program determines the how fast the blood glucose is rising or falling and considers how far the patient?s blood glucose is from the goal range, then calculates a percentage change in insulin requirements.  Nurses and pharmacists were educated to ensure the rationale for the protocol and tight glycemic control was understood. Evaluation and Outcomes: The percentage of blood glucose values within the goal range post-protocol implementation increased in the cardiovascular surgical intensive care unit (CV-ICU) and the cardiac care unit (CCU), by 71% and 78%, respectively while hypoglycemic episodes (blood glucose <60 mg/dL) were 0.6% (CV-ICU) and 1.2% (CCU) pre-implementation and were 0.7% (CV-ICU) and 0.7% (CCU) post-implementation.
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.titleTranslating Research into Practice: Glycemic Control of Critically Ill Patientsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/154372-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Translating Research into Practice: Glycemic Control of Critically Ill Patients</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">2006</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Sendelbach, Sue, RN, PhD, CCNS, FAHA</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Abbott Northwestern Hospital</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Clinical Nurse Researcher</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">Sue.Sendelbach@allina.com</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Jessica M. Swearingen, PharmD, BCPS; Robert Miner, MD</td></tr><tr><td colspan="2" class="item-abstract">Background: The benefits of tight glycemic control in critically ill patients have been well established in the literature and include decreases in mortality, organ dysfunction and length of stay.&nbsp; Purpose: The purpose of this evidence based project was two-fold: 1) to standardize the IV intensive insulin protocol; and 2) to decrease the goal blood glucose range to values recommended by the American Society of Endocrinologists.&nbsp; The study targeted patients who were both hyperglycemic and critically ill. Description: An interdisciplinary group, consisting of a clinical nurse specialist, a critical care pharmacist, staff nurses from the critical care units, an endocrinologist and hospitalist, convened to assess current blood glucose management, develop and implement an intensive insulin therapy protocol and evaluate the impact of the protocol on glycemic management in critically ill patients.&nbsp; The primary objective was to achieve and maintain blood glucose levels between 90-120 mg/dL Due to the complexity of the protocol, a computer program was developed to aid nurses in calculating insulin dose changes and to decrease risk for error.&nbsp; The protocol calculates insulin dose changes based on the patient?s last 2 blood glucose values.&nbsp; The computerized program determines the how fast the blood glucose is rising or falling and considers how far the patient?s blood glucose is from the goal range, then calculates a percentage change in insulin requirements.&nbsp; Nurses and pharmacists were educated to ensure the rationale for the protocol and tight glycemic control was understood. Evaluation and Outcomes: The percentage of blood glucose values within the goal range post-protocol implementation increased in the cardiovascular surgical intensive care unit (CV-ICU) and the cardiac care unit (CCU), by 71% and 78%, respectively while hypoglycemic episodes (blood glucose &lt;60 mg/dL) were 0.6% (CV-ICU) and 1.2% (CCU) pre-implementation and were 0.7% (CV-ICU) and 0.7% (CCU) post-implementation.</td></tr></table>en_GB
dc.date.available2011-10-26T12:56:52Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T12:56:52Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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