International journal of Nursing Education & Research

RESEARCH EVALUATING AN INTENSIVE INSULIN TRANSITION PROTOCOL IN AN INTENSIVE CARE SETTING

Reena Abraham*, Sai Sowmya G, Sai Manasa A, Siri, M Lohith

abrahamreena00@gmail.com

Glucose, basal insulin, hyperglycemic events

In this study, a standardized transition order set was evaluated to determine whether it provides effective and safe transition from a continuous insulin infusion regimen to a subcutaneous insulin regimen in patients in no cardiovascular surgery intensive care units. Methods: This study was a retrospective one. The study was not conducted on patients suffering from hyperosmolar hyperglycemic syndrome or diabetic ketoacidosis. The transition order set was implemented in 50 patients before and 50 patients after the order was implemented. In the days following the transition, blood glucose levels were monitored for up to three days Results: We analyzed the data from 57 patients: 42 before transition protocol and 15 after. The transitioned patients are all on basal insulin, compared with the prior to protocol group. It was found in 45% of cases that when patients followed the transition order, hypoglycemia did not increase as long as the blood sugars remained within the desired ranges. Those in the group before and after the protocol, there were 6.68 and 9.00 hyperglycemic events per person, respectively (p=0.05).). In the off-protocol group, sliding scale coverage reduced by 40% and correctional insulin coverage dramatically decreased (p=0.01). Conclusion: In transition regimens that included basal insulin, hyperglycemic events decreased, while hypoglycemic events did not increase. There were fewer hyperglycemic events in patients transitioning "per protocol"; their mean blood sugars were lower at 2 and 3 days; and their insulin requirements were lower. An ICU transition protocol that follows a standardized glycemic control protocol showed benefits