[Assessment of a nursing protocol for the management of hyperglicaemia in hospitalized patients].
OBJECTIVE
To assess the effectiveness of a nurse-led protocol for the management of hypo/ hyperglicaemia in a medical ward.


METHODS
Protocols for standard therapy, and parenteral intensive insulin therapy for severe hypo/hyperglycaemia in hospitalised patients were implemented.


METHODS
march-november 2007.


RESULTS
189 patients (19%) were labelled as "hyperglycaemic" at admission in Emergency Department. Median (+/-IQR) age was 77 (70-84) years, 41% were men, with known diabetes 74%, 18% had skin ulcers. Median glycaemia at admission was 144.5 (98-220) mg/dl. Thirty-six percent of patients was euglycaemic (60-126 mg/dl), 3% hypoglycaemic (<60 mg/dl). The glicaemic values ranged from 127-140 mg/dl (9% patients), from 141-280 mg/dl, (40%patients) and > 280 mg/dl (12% patients). The glicaemic values of the 14 patients requiring the intravenous intensive insulin regimen remained in a safe range (80-250 mg/dl) in the first 15 hours from the infusion start. No patient experienced a life-threatening hypoglycaemia nor hypoglycaemic coma. After three days on standard therapy, glicaemic levels were acceptable: 142 (98-185) pre-breakfast, 144(107-200) pre-lunch, 131 (102-190) pre-dinner, 183 (123-230) mg/dl postprandial.


CONCLUSIONS
Data showed the effectiveness and safety of a nurse-led protocol for the care of hyperglicaemia in a medical ward.
Ciardullo
Anna Vittoria
AV
Medicina Intena, Ospedale Ramazzini, AUSL, Modena.
Rossetti
Lorella
L
Daghio
Maria Monica
MM
Morselli
Anna
A
Malavasi
Erica
E
Pasqualini
Antonella
A
Po
Iolanda
I
Gilioli
Fabio
F
Di Donato
Carlo
C
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006760:Hospitalization; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy* / Q000451:nursing*; D008297:Male; D009730:Nursing Assessment