Impact of a nurse-managed hyperglycemic intensive insulin protocol on glucose control

Many critically ill patients have poorly controlled glucose levels which can lead to increased mortality, morbidity, and length of stay. Tight glycemic control in the critically ill patient is challenging to manage by both nurses and physicians. The purpose of this study is to compare the effectiveness of a nurse-managed hyperglycemia protocol to that of a standardized hyperglycemia protocol with critically ill patients. Study inclusion criteria for the sample of 50 intensive care unit (ICU) patients will be an ICU stay of longer than 48 hours and to have received insulin for longer than 24 hours. Data collected will be blood glucose at 48 hours post-ICU admission, length of time of blood glucose levels less than 150 and 110, and daily insulin dosage. Group 1 will include 25 consecutively selected admitted ICU patients, who receive the standardized hyperglycemia protocol. Group 2 will include 25 ICU patients consecutively admitted after nurse and physician education and implementation of a nurse-managed hyperglycemia protocol. Statistical analysis will include comparisons of group differences in blood glucose, times, and insulin dosage. Findings of this study will provide information on the effectiveness of a nurse-managed hyperglycemia protocol.