title: New insulin infusion protocol Improves blood glucose control in hospitalized patients without increasing hypoglycemia.
abstract: BACKGROUND
  Aggressive treatment of hyperglycemia in hospitalized patients can improve clinically important outcomes. At the University of Washington Medical Center a quality improvement project was conducted to develop and implement a standardized insulin infusion protocol for use throughout the institution.
  
  
  METHODS
  The insulin infusion protocol was piloted on critical and non-critical care inpatient units. Safety and efficacy data were collected for a one-month period on each unit.
  
  
  RESULTS
  A total of 156 patients were evaluated. The incidence of hypoglycemia was lower for the study group than the historical controls, as was the mean percentage of time patients were hyperglycemic, 15% +/- 2.3% vs. 33% +/- 2.6% for the critical care subgroup (p < .0001) and 18% +/- 2.4% vs. 56% +/- 2.3% for the non-critical care subgroup (p < .0001).
  
  
  CONCLUSIONS
  The insulin infusion protocol better met the insulin requirements of our patients and achieved better glycemic control than previous protocols at the institution. In addition, there was no increase in hypoglycemia despite the use of the protocol in non-critical care units with higher patient-to-nurse ratios, suggests that insulin infusion therapy can be safely used outside of critical care units.
authors.affiliation: University of Washington Medical Center, USA.
authors.forename: Susanna Y
authors.initials: SY
authors.lastname: Ku
authors.forename: Cindy A
authors.initials: CA
authors.lastname: Sayre
authors.forename: Irl B
authors.initials: IB
authors.lastname: Hirsch
authors.forename: Janet L
authors.initials: JL
authors.lastname: Kelly
mesh_terms: D001786:Blood Glucose / Q000032:analysis*; D002985:Clinical Protocols / Q000592:standards*; D003422:Critical Care; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy; D019317:Evidence-Based Medicine; D006760:Hospitalization; D006801:Humans; D007003:Hypoglycemia / Q000188:drug therapy*; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D012449:Safety; D016896:Treatment Outcome; D014861:Washington
chemical_list: D001786:Blood Glucose; D007328:Insulin