Efficacy of Nurses Led Insulin Protocol to Control Blood Glucose among Critically Ill Patients

Abstract

Aim and objectives: This study aimed to determine the efficacy of nurse led insulin protocol to control blood glucose among critically ill patients. Background: Hyperglycemia is a common problem among critically ill patients in the ICUs that consistently linked with worsened clinical outcomes in various groups of patients. Thus, ensuring effectiveness, safety and a high-quality glycemic control can be achieved with a protocol that combining continuous intravenous insulin with frequent bedside blood glucose monitoring. Design: Quasi-experimental design was used in this study. Methods: This study was conducted in the ICU departments at Alexandria Main University Hospital on 60 newly admitted hyperglycemic critically ill patients. They randomly assigned into two groups; control group and intervention group. The nurse led insulin protocol was applied among the study group, while the control group managed by the routine ICU management. Results: The hyperglycemic mechanically ventilated patients who were managed by the nurse led insulin protocol experienced lower mean blood glucose level and lower glucose variability than those who were managed by routine management of the ICUs. Conclusion: The nurse led insulin protocol was an effective to control blood glucose level among critically ill patients. Relevance to the clinical practices: nurses’ led insulin protocol has strongly and consistently linked with better glycemic control and improved clinical outcomes in various groups of patients. Implementation of nurse led protocols increases nurses’ autonomy; a concept that has been associated with increasing their perceptions of improved quality of care and job satisfaction.