title: Pharmacist designed and nursing-driven insulin infusion protocol to achieve and maintain glycemic control in critical care patients.
abstract: The objective of the quality assessment was to develop and evaluate a modified nurse-driven insulin infusion protocol for intensive care unit patients and compare the hours needed to achieve a targeted glycemic range and duration within a goal range (80-110 mg/dL) to that of our traditional protocol. With our modified nurse-driven protocol, the median time to reach the goal for patients with diabetes was 11.5 hours versus 21.5 hours with the traditional protocol. Patients without diabetes reached the goal in 8 hours with the modified-nurse driven protocol versus 12 hours with the traditional protocol. Percentage of time within the goal improved from 14.6% to 20.7% for patients with diabetes and from 7% to 24.3% for patients without diabetes.
authors.affiliation: Crozer Chester Medical Center, One Medical Center Boulevard, Upland, PA 19013, USA. Lucinda.Scheuren@crozer.org
authors.forename: Lucinda
authors.initials: L
authors.lastname: Scheuren
authors.forename: Brooke
authors.initials: B
authors.lastname: Baetz
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Cawley
authors.forename: RuthAnn
authors.initials: R
authors.lastname: Fitzpatrick
authors.forename: Riad
authors.initials: R
authors.lastname: Cachecho
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D002985:Clinical Protocols; D003422:Critical Care / Q000458:organization & administration*; D016638:Critical Illness / Q000451:nursing; D016903:Drug Monitoring; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D015274:Interdepartmental Relations; D007902:Length of Stay / Q000706:statistics & numerical data; D008875:Middle Aged; D024802:Nurse's Role; D015403:Nursing Evaluation Research; D009741:Nursing Staff, Hospital / Q000193:education / Q000458:organization & administration*; D010348:Patient Care Team / Q000458:organization & administration; D010414:Pennsylvania; D010607:Pharmacy Service, Hospital / Q000458:organization & administration*; D010865:Pilot Projects; D015397:Program Evaluation; D011785:Quality Assurance, Health Care; D013997:Time Factors
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin