2.50
Hdl Handle:
http://hdl.handle.net/10755/157098
Category:
Abstract
Type:
Presentation
Title:
Tight Glycemic Control: The effectiveness of a computerized insulin dose calculator
Author(s):
Dumont, Cheryl; Kiracofe, Rhonda; Barch, Cyril; Sabbagh, Leigh Ann; David, Mary; Ryder, Nicole; Rudy, Kim; Harvey, Bonnie; Wenzel, Ruth; Dellinger, Lisa; Louzonis, Darlene
Author Details:
Cheryl Dumont, Winchester Medical Center, Winchester, Virgina, USA, email: cdumont@valleyhealthlink.com; Rhonda Kiracofe; Cyril Barch; Leigh Ann Sabbagh; Mary David; Nicole Ryder; Kim Rudy; Bonnie Harvey; Ruth Wenzel; Lisa Dellinger; Darlene Louzonis
Abstract:
PURPOSE: The purpose of this study is to examine the effects of using a computerized insulin dosing tool, to facilitate tight glycemic control. The research questions are: (1.) Is there a difference in tight glycemic control based on the nurses' use of a computerized dose calculator versus a paper protocol? (2.) Is there a difference in nurse satisfaction with the process of tight glycemic control based on the nurses' use of a computerized dose calculator versus a paper protocol? BACKGROUND: Tight glycemic control is important to patient outcomes but the process of tight glycemic control is risk prone and labor intensive for nurses. Technology offers a computerized dose calculator for intravenous (IV) insulin dosing that may improve glycemic control. There have been no randomized controlled trials examining the effects of nursesÆ use of a computerized dose calculator compared to a paper protocol for glycemic control, and nurse satisfaction with the process has not been examined. METHODS: This is an ongoing prospective randomized controlled trial of the safety and efficacy of a computerized dose calculator (EndoTool) compared with a paper protocol for IV insulin dosing. Glycemic control is being measured in mg/dl blood glucose, percent measures in target range, time to reach target and number of hypoglycemic events. The sample will be 300 intensive care patients, 150 randomized to the computerized dose calculator and 150 in the control group who will receive usual care with the paper protocol. Nurses providing care for these patients will be a cohort of ICU nurses who usually work in the study units and will be responsible for the patientsÆ total care. RESULTS: An analysis of 42 patients demonstrated that the average blood glucose was with EndoTool 145 mg/dl versus 154 mg/dl with the paper protocol. Time to target was 3 (1.5) hours with EndoTool, 5 (6) hours with the paper protocol. Measures in target range were 63% with EndoTool versus 55% with the paper protocol and there have been no hypoglycemic episodes (< 40 mg/dl) with EndoTool, four with the paper protocol. These results did not reach statistical significance. Nurse satisfaction, N = 24, on a scale of 1 to 10, 1 meaning very unsatisfied and 10 very satisfied, was 8.4 (1.6) with EndoTool and 4.8 (2.5) with the paper protocol (t = -4.959, p = .000) CONCLUSIONS: The sample size is currently not large enough to make conclusions. We are also collecting data on our patients outcomes for future analysis of the relationships between glucose control and outcomes. We intend to continue to collect data to achieve a sample size of 300 patients and plan to survey another 30 nurses. At this time the nurses are very happy with the EndoTool as a dose calculator for IV insulin.
Repository Posting Date:
26-Oct-2011
Date of Publication:
26-Oct-2011
Citation:
2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.
Conference Date:
2009
Conference Name:
National Teaching Institute and Critical Care Exposition
Conference Host:
American Association of Critical-Care Nurses
Conference Location:
New Orleans, Louisiana, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleTight Glycemic Control: The effectiveness of a computerized insulin dose calculatoren_GB
dc.contributor.authorDumont, Cherylen_GB
dc.contributor.authorKiracofe, Rhondaen_GB
dc.contributor.authorBarch, Cyrilen_GB
dc.contributor.authorSabbagh, Leigh Annen_GB
dc.contributor.authorDavid, Maryen_GB
dc.contributor.authorRyder, Nicoleen_GB
dc.contributor.authorRudy, Kimen_GB
dc.contributor.authorHarvey, Bonnieen_GB
dc.contributor.authorWenzel, Ruthen_GB
dc.contributor.authorDellinger, Lisaen_GB
dc.contributor.authorLouzonis, Darleneen_GB
dc.author.detailsCheryl Dumont, Winchester Medical Center, Winchester, Virgina, USA, email: cdumont@valleyhealthlink.com; Rhonda Kiracofe; Cyril Barch; Leigh Ann Sabbagh; Mary David; Nicole Ryder; Kim Rudy; Bonnie Harvey; Ruth Wenzel; Lisa Dellinger; Darlene Louzonisen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157098-
dc.description.abstractPURPOSE: The purpose of this study is to examine the effects of using a computerized insulin dosing tool, to facilitate tight glycemic control. The research questions are: (1.) Is there a difference in tight glycemic control based on the nurses' use of a computerized dose calculator versus a paper protocol? (2.) Is there a difference in nurse satisfaction with the process of tight glycemic control based on the nurses' use of a computerized dose calculator versus a paper protocol? BACKGROUND: Tight glycemic control is important to patient outcomes but the process of tight glycemic control is risk prone and labor intensive for nurses. Technology offers a computerized dose calculator for intravenous (IV) insulin dosing that may improve glycemic control. There have been no randomized controlled trials examining the effects of nurses&AElig; use of a computerized dose calculator compared to a paper protocol for glycemic control, and nurse satisfaction with the process has not been examined. METHODS: This is an ongoing prospective randomized controlled trial of the safety and efficacy of a computerized dose calculator (EndoTool) compared with a paper protocol for IV insulin dosing. Glycemic control is being measured in mg/dl blood glucose, percent measures in target range, time to reach target and number of hypoglycemic events. The sample will be 300 intensive care patients, 150 randomized to the computerized dose calculator and 150 in the control group who will receive usual care with the paper protocol. Nurses providing care for these patients will be a cohort of ICU nurses who usually work in the study units and will be responsible for the patients&AElig; total care. RESULTS: An analysis of 42 patients demonstrated that the average blood glucose was with EndoTool 145 mg/dl versus 154 mg/dl with the paper protocol. Time to target was 3 (1.5) hours with EndoTool, 5 (6) hours with the paper protocol. Measures in target range were 63% with EndoTool versus 55% with the paper protocol and there have been no hypoglycemic episodes (< 40 mg/dl) with EndoTool, four with the paper protocol. These results did not reach statistical significance. Nurse satisfaction, N = 24, on a scale of 1 to 10, 1 meaning very unsatisfied and 10 very satisfied, was 8.4 (1.6) with EndoTool and 4.8 (2.5) with the paper protocol (t = -4.959, p = .000) CONCLUSIONS: The sample size is currently not large enough to make conclusions. We are also collecting data on our patients outcomes for future analysis of the relationships between glucose control and outcomes. We intend to continue to collect data to achieve a sample size of 300 patients and plan to survey another 30 nurses. At this time the nurses are very happy with the EndoTool as a dose calculator for IV insulin.en_GB
dc.date.available2011-10-26T19:25:09Z-
dc.date.issued2011-10-26en_GB
dc.date.accessioned2011-10-26T19:25:09Z-
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.conference.date2009en_GB
dc.conference.nameNational Teaching Institute and Critical Care Expositionen_GB
dc.conference.hostAmerican Association of Critical-Care Nursesen_GB
dc.conference.locationNew Orleans, Louisiana, USAen_GB
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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