title: Glycemic control after coronary bypass graft: using intravenous insulin regulated by a computerized system.
abstract: Hyperglycemia is a risk factor for poor outcomes in patients who undergo coronary artery bypass grafting. Poor outcomes led a multidisciplinary team to formulate a protocol to improve glycemic control of inpatients who had diabetes or hyperglycemia. This protocol initiated an intravenous (i.v.) insulin infusion that is regulated by a computerized system that is known as a Glucommander, and guides the surgeon and nurses to an easy transition to subcutaneous insulin. As a result of implementing the computerized system which regulated i.v. insulin, glycemic control improved during surgery and postoperatively. Additionally, physician and nurse satisfaction increased because of better glycemic control using a reliable, safe, and easy tool for the management of insulin infusions and there were fewer interruptive phone calls to physicians.
authors.affiliation: Moses Cone Health System, 1200 North Elm Street, Greensboro, NC 27401, USA. elaine.button@mosescone.com
authors.forename: Elaine
authors.initials: E
authors.lastname: Button
authors.forename: Patty
authors.initials: P
authors.lastname: Keaton
mesh_terms: D000465:Algorithms; D001291:Attitude of Health Personnel; D015400:Clinical Nursing Research; D002985:Clinical Protocols; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003422:Critical Care / Q000379:methods; D016903:Drug Monitoring / Q000379:methods* / Q000451:nursing; D004360:Drug Therapy, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D004867:Equipment Design; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007262:Infusions, Intravenous; D007279:Injections, Subcutaneous; D007328:Insulin / Q000627:therapeutic use; D007332:Insulin Infusion Systems / Q000706:statistics & numerical data; D009657:North Carolina; D024802:Nurse's Role; D009730:Nursing Assessment; D015403:Nursing Evaluation Research; D010348:Patient Care Team / Q000458:organization & administration; D011182:Postoperative Care / Q000379:methods / Q000451:nursing; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin