Literature DB >> 19885201

Improving hyperglycemia in the hospital: outcomes of a nursing in-service to evaluate acceptance of a web-based insulin infusion calculator.

Kathie L Hermayer1, Timothy V Hushion, Pamela C Arnold, Barbara Wojciechowski.   

Abstract

BACKGROUND: Many insulin infusion protocols are available for clinical use. We developed a Web-based, online intravenous insulin infusion calculator (IVIIC) for use in our intensive care and medical-surgical units.
METHODS: In September 2006, we implemented a quality improvement project: an online survey to evaluate the acceptance of this protocol by the nursing staff. Of the 103 registered nurses (RNs) who participated, there was no difference among experience levels of the RNs (>/= or <5 years) or among durations that RNs had been working within their unit (>/= or <2 years).
RESULTS: The nurses were surveyed regarding the use and interpretation of the protocol, their comfort with, confidence in, and experience in using the protocol. More than 80% of the RNs found the protocol easy to implement, easy to interpret, and successful in controlling the blood glucose levels. Approximately 71% (+/-9%) of the RNs were comfortable with the tight blood glucose levels of the protocol. The nurses' confidence with the protocol was 82% (+/-8%), likely because 70% (+/-9%) of the nurses believed the training to be adequate. Significantly less than 25% of the RNs (18 +/- 7%) believed it was necessary to deviate from the protocol. More than 85% of the RNs appreciated the ability to make changes at their level of practice (92 +/- 5%).
CONCLUSIONS: In summary, the IVIIC is well accepted by RNs for care of hyperglycemia in a hospital setting.

Entities:  

Keywords:  diabetes; hyperglycemia; hypoglycemia; intravenous insulin; nursing; patient safety

Year:  2008        PMID: 19885201      PMCID: PMC2769722          DOI: 10.1177/193229680800200306

Source DB:  PubMed          Journal:  J Diabetes Sci Technol        ISSN: 1932-2968


  18 in total

1.  Intensive insulin therapy in critically ill patients.

Authors:  G van den Berghe; P Wouters; F Weekers; C Verwaest; F Bruyninckx; M Schetz; D Vlasselaers; P Ferdinande; P Lauwers; R Bouillon
Journal:  N Engl J Med       Date:  2001-11-08       Impact factor: 91.245

2.  American College of Endocrinology position statement on inpatient diabetes and metabolic control.

Authors:  Alan J Garber; Etie S Moghissi; Edwin D Bransome; Nataniel G Clark; Stephen Clement; Rhoda H Cobin; Anthony P Furnary; Irl B Hirsch; Philip Levy; Robert Roberts; Greet Van den Berghe; Virginia Zamudio
Journal:  Endocr Pract       Date:  2004 Mar-Apr       Impact factor: 3.443

Review 3.  Nurse care coordination for diabetes: a literature review and synthesis.

Authors:  Sarah Ingersoll; Sharon M Valente; Jan Roper
Journal:  J Nurs Care Qual       Date:  2005 Jul-Sep       Impact factor: 1.597

4.  Hyperglycemia: an independent marker of in-hospital mortality in patients with undiagnosed diabetes.

Authors:  Guillermo E Umpierrez; Scott D Isaacs; Niloofar Bazargan; Xiangdong You; Leonard M Thaler; Abbas E Kitabchi
Journal:  J Clin Endocrinol Metab       Date:  2002-03       Impact factor: 5.958

5.  Glucommander: a computer-directed intravenous insulin system shown to be safe, simple, and effective in 120,618 h of operation.

Authors:  Paul C Davidson; R Dennis Steed; Bruce W Bode
Journal:  Diabetes Care       Date:  2005-10       Impact factor: 19.112

6.  New insulin infusion protocol Improves blood glucose control in hospitalized patients without increasing hypoglycemia.

Authors:  Susanna Y Ku; Cindy A Sayre; Irl B Hirsch; Janet L Kelly
Journal:  Jt Comm J Qual Patient Saf       Date:  2005-03

7.  Tight glycemic control in diabetic coronary artery bypass graft patients improves perioperative outcomes and decreases recurrent ischemic events.

Authors:  Harold L Lazar; Stuart R Chipkin; Carmel A Fitzgerald; Yusheng Bao; Howard Cabral; Carl S Apstein
Journal:  Circulation       Date:  2004-03-08       Impact factor: 29.690

8.  Outcomes of a cardiothoracic intensive care web-based online intravenous insulin infusion calculator study at a Medical University Hospital.

Authors:  Kathie L Hermayer; Diane E Neal; Timothy V Hushion; Michael G Irving; Pamela C Arnold; Lisa Kozlowski; Martha R Stroud; Frank B Kerr; John M Kratz
Journal:  Diabetes Technol Ther       Date:  2007-12       Impact factor: 6.118

9.  Practical closed-loop insulin delivery. A system for the maintenance of overnight euglycemia and the calculation of basal insulin requirements in insulin-dependent diabetics.

Authors:  N H White; D Skor; J V Santiago
Journal:  Ann Intern Med       Date:  1982-08       Impact factor: 25.391

10.  Effect of an intensive glucose management protocol on the mortality of critically ill adult patients.

Authors:  James Stephen Krinsley
Journal:  Mayo Clin Proc       Date:  2004-08       Impact factor: 7.616

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  1 in total

1.  Failure to control hyperglycemia in noncritically ill diabetes patients despite standard glycemic management in a hospital setting.

Authors:  Katharina Maria Neubauer; Lukas Schaupp; Johannes Plank; Thomas Augustin; Selma Isabella Mautner; Bernd Tschapeller; Thomas Rudolf Pieber
Journal:  J Diabetes Sci Technol       Date:  2013-03-01
  1 in total

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