2.50
Hdl Handle:
http://hdl.handle.net/10755/157151
Category:
Abstract
Type:
Presentation
Title:
Creating a Culture Change: Tight Glucose Control in a Trauma/Neuro Intensive Care Unit
Author(s):
O'Neill, Susan
Author Details:
Susan O'Neill, Lehigh Valley Hospital, Allentown, Pennsylvania, USA, email: susan.o'neill@lvh.com
Abstract:
PURPOSE: Examine methods utilized to teach physicians and nurses a new protocol designed to control critically injured patient's blood glucose levels between 80-110 mg/dl in a level one trauma center over a sixteen month period. Description: The majority of clinical research has demonstrated that patient's cared for in Surgical and Medical ICU's have decreased mortality and morbidity when their blood glucose levels were maintained within a target range of 80-110 mg/dl. Although less research is presented in the literature demonstrating positive outcomes with tight glucose control in the trauma population, our physician and nurse team members decided to adopt the concept. We incorporated a paper based columnar tool that proved to be a challenge to the nurse educator and leader of this project. Creative teaching strategies included initially utilizing the 90-140 mg/dl target until nurses were comfortable using the complicated tool before adopting tighter control, frequent staff feedback in the form of e-mails, screen shots of blood glucose trends, informative bulletin boards, spending time at the bedside teaching, and providing data, such as percentages of time spent within target range daily by working with Information Services to generate real time reports. EVALUATION: The project was initiated in May of 2007. Patient's blood glucose levels achieved within the range of 80-110 mg/dl currently average around 50 % each month, improved from 30% last year. The greatest learning achieved from our project is that culture changes take time. Acceptance of hyperglycemia related to the stress response for so many years is the most challenging aspect of this culture change. More research is needed to study patient outcomes for specialized populations, such as trauma and neuro patients when utilizing tight glucose control. A retrospective and IRB study is in progress including such variable as length of stay, ventilator days and adverse events.
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.titleCreating a Culture Change: Tight Glucose Control in a Trauma/Neuro Intensive Care Uniten_GB
dc.contributor.authorO'Neill, Susanen_GB
dc.author.detailsSusan O'Neill, Lehigh Valley Hospital, Allentown, Pennsylvania, USA, email: susan.o'neill@lvh.comen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157151-
dc.description.abstractPURPOSE: Examine methods utilized to teach physicians and nurses a new protocol designed to control critically injured patient's blood glucose levels between 80-110 mg/dl in a level one trauma center over a sixteen month period. Description: The majority of clinical research has demonstrated that patient's cared for in Surgical and Medical ICU's have decreased mortality and morbidity when their blood glucose levels were maintained within a target range of 80-110 mg/dl. Although less research is presented in the literature demonstrating positive outcomes with tight glucose control in the trauma population, our physician and nurse team members decided to adopt the concept. We incorporated a paper based columnar tool that proved to be a challenge to the nurse educator and leader of this project. Creative teaching strategies included initially utilizing the 90-140 mg/dl target until nurses were comfortable using the complicated tool before adopting tighter control, frequent staff feedback in the form of e-mails, screen shots of blood glucose trends, informative bulletin boards, spending time at the bedside teaching, and providing data, such as percentages of time spent within target range daily by working with Information Services to generate real time reports. EVALUATION: The project was initiated in May of 2007. Patient's blood glucose levels achieved within the range of 80-110 mg/dl currently average around 50 % each month, improved from 30% last year. The greatest learning achieved from our project is that culture changes take time. Acceptance of hyperglycemia related to the stress response for so many years is the most challenging aspect of this culture change. More research is needed to study patient outcomes for specialized populations, such as trauma and neuro patients when utilizing tight glucose control. A retrospective and IRB study is in progress including such variable as length of stay, ventilator days and adverse events.en_GB
dc.date.available2011-10-26T19:28:01Z-
dc.date.issued2011-10-26en_GB
dc.date.accessioned2011-10-26T19:28:01Z-
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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