Nurse-led Insulin Protocol Improves Blood Sugar Control in ICU
Author Information
Author(s): Alm-Kruse Kristin, Bull Eva M, Laake Jon H
Primary Institution: Rikshospitalet Medical Centre
Hypothesis
Can a nurse-led implementation of a strict glycaemic control algorithm improve blood glucose levels in ICU patients?
Conclusion
The study showed that while glycaemic control improved, there was also an increase in severe hypoglycaemic episodes, indicating a need for algorithm revision.
Supporting Evidence
- Blood glucose levels improved from a median of 6.6 mmol/L to 5.9 mmol/L after the new protocol.
- The percentage of blood glucose samples within the target range increased from 33% to 45.8%.
- The incidence of severe hypoglycaemia increased from 2.4% to 8.9% after implementation of the protocol.
Takeaway
Nurses used a new plan to help keep patients' blood sugar levels normal, but it also caused more patients to have dangerously low blood sugar.
Methodology
The study involved a retrospective analysis of blood glucose results before and after implementing a new insulin protocol in an ICU.
Potential Biases
There may be bias due to the retrospective nature of the analysis and the lack of control over external factors affecting blood glucose levels.
Limitations
The study did not formally assess the effect on mortality and had potential biases in data collection.
Participant Demographics
Patients in the ICU had a median age of 56 years, with a nurse-to-patient ratio of 1:1.
Statistical Information
P-Value
p<0.001
Confidence Interval
95% confidence interval 0.54 to 0.62
Statistical Significance
p<0.001
Digital Object Identifier (DOI)
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