2.50
Hdl Handle:
http://hdl.handle.net/10755/182471
Category:
Abstract
Type:
Presentation
Title:
Tight Glycemic Control: An Examination of the Effect of Technology on Nurses' Processes of Care
Author(s):
Dumont, Cheryl
Author Details:
Cheryl Dumont, PhD, RN, Winchester Medical Center, Winchester, Virginia, USA, email: cdumont@valleyhealthlink.com
Abstract:
This study compares the safety and efficacy of intravenous insulin dosing using a computerized dose calculator (CDC) versus paper protocol (PP). The proposed sample will be 300 intensive care cardiac surgery patients, randomized to the CDC or PP. The nurse sample is a cohort of nurses who are responsible for the patients total care. Preliminary analysis demonstrated no differences between the CDC (N = 89) and PP (N = 105) groups based on demographics, presence of infection, or catecholamine infusions. There were no significant differences in mean (standard deviation) glucose, 139 (16) vs 142 (20) mg/dL, or time to reach target range (80 150 mg/dL), 3.7 (2.4) versus 3.9 (2.4) hours, between the CDC and the PP groups, respectively. A statistically significant increased percent of glucose measures remained in target range with the CDC, 69 (17)% versus PP, 60 (18)% (Z = -3.490, p < 0.001). Glucose variance and hypoglycemic events were less in the CDC group. Nurse satisfaction (N = 44), measured with an investigator designed 10 point numerical rating scale, 1 being very unsatisfied and 10 very satisfied, was higher for the CDC than the PP, scoring 8.4 (1.4) versus 4.8 (2.4) (Z = -5.055, p < 0.001). Nurses perceived frequency of deviation from the protocol was less with the CDC than the PP, 2.7 (2.2) versus 7.5 (2.2) (Z = -5.393, p < 0.001). Data collection and analysis is ongoing. The results will be used to guide future nursing practice and resource allocation in glycemic control. References: Aragon, D. (2006). Evaluation of nursing work effort and perceptions about blood glucose testing in tight glycemic control. AJCC, 15(4), 370-377.; Bland, D. K., Fankhanel, Y., Langford, E., Lee, M., Lee, S. W., Maloney, C., et al. (2005). Intensive versus modified conventional control of blood glucose level in medical intensive care patients: A pilot study. AJCC, 14(5), 370-376.; Krinsley, J. S. (2004). Effect of an intensive glucose management protocol on the mortality of critically ill adult patients. Mayo Clin Proc, 79(8), 992-1000.; Van den Berghe, G., Wilmer, A., Hermans, G., Meersseman, W., Wouters, P. J., Milants, I., et al. (2006). Intensive insulin therapy in the medical ICU. N Engl J Med, 354(5), 449-461.
Repository Posting Date:
28-Oct-2011
Date of Publication:
28-Oct-2011
Conference Date:
2009
Conference Name:
ANCC National Magnet Conference
Conference Host:
American Nurses Credentialing Center
Conference Location:
Louisville, Kentucky, USA
Description:
"Magnet: Inspiring Innovation, Achieving Outcomes" was the theme and "Explore the relationship among leadership, innovation, and nursing practice outcomes" was the goal of the 13th American Nurses Credentialing Center (ANCC) National Magnet Conference, held 1-3 October, 2009 in Louisville, Kentucky, 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_US
dc.typePresentationen_GB
dc.titleTight Glycemic Control: An Examination of the Effect of Technology on Nurses' Processes of Careen_GB
dc.contributor.authorDumont, Cherylen_US
dc.author.detailsCheryl Dumont, PhD, RN, Winchester Medical Center, Winchester, Virginia, USA, email: cdumont@valleyhealthlink.comen_US
dc.identifier.urihttp://hdl.handle.net/10755/182471-
dc.description.abstractThis study compares the safety and efficacy of intravenous insulin dosing using a computerized dose calculator (CDC) versus paper protocol (PP). The proposed sample will be 300 intensive care cardiac surgery patients, randomized to the CDC or PP. The nurse sample is a cohort of nurses who are responsible for the patients total care. Preliminary analysis demonstrated no differences between the CDC (N = 89) and PP (N = 105) groups based on demographics, presence of infection, or catecholamine infusions. There were no significant differences in mean (standard deviation) glucose, 139 (16) vs 142 (20) mg/dL, or time to reach target range (80 150 mg/dL), 3.7 (2.4) versus 3.9 (2.4) hours, between the CDC and the PP groups, respectively. A statistically significant increased percent of glucose measures remained in target range with the CDC, 69 (17)% versus PP, 60 (18)% (Z = -3.490, p &lt; 0.001). Glucose variance and hypoglycemic events were less in the CDC group. Nurse satisfaction (N = 44), measured with an investigator designed 10 point numerical rating scale, 1 being very unsatisfied and 10 very satisfied, was higher for the CDC than the PP, scoring 8.4 (1.4) versus 4.8 (2.4) (Z = -5.055, p &lt; 0.001). Nurses perceived frequency of deviation from the protocol was less with the CDC than the PP, 2.7 (2.2) versus 7.5 (2.2) (Z = -5.393, p &lt; 0.001). Data collection and analysis is ongoing. The results will be used to guide future nursing practice and resource allocation in glycemic control. References: Aragon, D. (2006). Evaluation of nursing work effort and perceptions about blood glucose testing in tight glycemic control. AJCC, 15(4), 370-377.; Bland, D. K., Fankhanel, Y., Langford, E., Lee, M., Lee, S. W., Maloney, C., et al. (2005). Intensive versus modified conventional control of blood glucose level in medical intensive care patients: A pilot study. AJCC, 14(5), 370-376.; Krinsley, J. S. (2004). Effect of an intensive glucose management protocol on the mortality of critically ill adult patients. Mayo Clin Proc, 79(8), 992-1000.; Van den Berghe, G., Wilmer, A., Hermans, G., Meersseman, W., Wouters, P. J., Milants, I., et al. (2006). Intensive insulin therapy in the medical ICU. N Engl J Med, 354(5), 449-461.en_GB
dc.date.available2011-10-28T15:25:43Z-
dc.date.issued2011-10-28en_GB
dc.date.accessioned2011-10-28T15:25:43Z-
dc.conference.date2009en_US
dc.conference.nameANCC National Magnet Conferenceen_US
dc.conference.hostAmerican Nurses Credentialing Centeren_US
dc.conference.locationLouisville, Kentucky, USAen_US
dc.description"Magnet: Inspiring Innovation, Achieving Outcomes" was the theme and "Explore the relationship among leadership, innovation, and nursing practice outcomes" was the goal of the 13th American Nurses Credentialing Center (ANCC) National Magnet Conference, held 1-3 October, 2009 in Louisville, Kentucky, USA.en_US
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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