title: Improving glycaemic control in a metabolically stressed patient in ICU.
abstract: This article describes a clinical experience where the careful application of problem-solving skills has resulted in positive changes in glycaemic care in a critical care environment. The metabolic stress response to trauma injuries leads to episodes of hyperglycaemia. The application of a problem-solving process has resulted in greater understanding of best practice of the management of this problem. The importance of strict control of blood glucose levels in the critically ill patient is highlighted. Although the practice areas in this article is a specialized intensive care environment, in light of recent government-led recognition that many patients in hospital are increasingly ill (Department of Health (DoH), 1998a), this situation may arise in many ward environments.
authors.affiliation: Adult Nursing (Critical Care), University of Central England, Birmingham, UK.
authors.forename: Claire
authors.initials: C
authors.lastname: Perkins
mesh_terms: D019985:Benchmarking; D001786:Blood Glucose / Q000032:analysis; D003422:Critical Care / Q000379:methods* / Q000592:standards; D016638:Critical Illness / Q000628:therapy*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology / Q000378:metabolism / Q000517:prevention & control; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods / Q000451:nursing / Q000592:standards; D009104:Multiple Trauma / Q000150:complications; D024802:Nurse's Role; D009730:Nursing Assessment; D009736:Nursing Process; D010347:Patient Care Planning; D011340:Problem Solving; D013312:Stress, Physiological / Q000150:complications / Q000378:metabolism
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin