Intensive insulin therapy in the critically ill geriatric patient.
Tight glucose control can significantly improve outcomes of critically ill geriatric patients in the critical care unit (CCU). In the past, blood glucose levels were managed by a point-of-care testing every 4 to 6 hours and using a sliding scale of insulin therapy. This article explores the need for more intensive intravenous insulin therapies. Studies have shown that patient outcomes improve by having a specific set of standing orders, a well-defined algorithm, and empowering the CCU nurses with these tools. Methods for initiating intensive intravenous insulin therapies are discussed along with some of the biggest challenges faced by CCU nurses at the bedside.
Humbert
Jennifer
J
Penn State Diabetes Center, Penn State College of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA. jhumbert2@psu.edu
Gallagher
Kendra
K
Gabbay
Robert
R
Dellasega
Cheryl
C
D000368:Aged; D000465:Algorithms; D019985:Benchmarking; D002985:Clinical Protocols; D003422:Critical Care / Q000458:organization & administration*; D016638:Critical Illness / Q000628:therapy; D016903:Drug Monitoring / Q000379:methods / Q000451:nursing; D006301:Health Services Needs and Demand; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology / Q000378:metabolism / Q000517:prevention & control*; D007003:Hypoglycemia / Q000209:etiology / Q000378:metabolism / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D007262:Infusions, Intravenous; D007328:Insulin / Q000009:adverse effects / Q000627:therapeutic use*; D024802:Nurse's Role; D019095:Point-of-Care Systems / Q000458:organization & administration; D016896:Treatment Outcome
D007004:Hypoglycemic Agents; D007328:Insulin