Ebook The Statistical Variance Of Blood Glucose Levels Of Medicial Intensive Care Unit Patients While On An Insulin Infusion Protocol
Nurses and physicians caring for critically ill patients in Intensive Care Units (ICUs) are continually looking for ways to improve patient outcomes and decrease morbidity and mortality. In 2004 the mortality rate for ICU patients was approximately 20% (Lewis et al., 2004). Hyperglycemia is a common problem in the ICU patient population in both those with a known diagnosis of diabetes and those without (Umpierrez et al., 2002). The incidence of hyperglycemia may be as high as 50% in the nondiabetic ICU patient (Roberts & Hamedeni, 2004). Consequently, many ICUs have started to implement insulin infusion protocols (IIPs) to combat the hyperglycemia found in the ICU patient.
Hyperglycemia in the hospital setting is thought to lead to increased mortality and morbidity, increased length of stay, decreased wound healing, and increased infection rates (Van Den Berghe, 2001). Intensive study into IIPs has begun to emerge in hospitals around the world to decrease the incidence of hyperglycemia in ICU patients.
The precursor to hyperglycemia in patients, even those without a known diabetes diagnosis, is critical illness. The stress that critical illness applies to the patient has a large impact on many metabolic pathways, including cytokines, hormones, and nervous system counter-regulatory signals. Glucogenolysis, which results in an increase in blood glucose, is caused by increased levels of glucagons, cortisol, catecholamines, and growth hormones (Fraser, Lois, Robley, Peno-Green, 2006).
CONTENTS
1. INTRODUCTION
- Problem Statement
Purpose of the Study
Setting
Definition of Terms
Significance for Nursing
Framework
Conclusion
2. LITERATURE REVIEW
- Hyperglycemia
Insulin Infusion Protocols
Nurses’ Experience
Blood Glucose Variance
Summary
3. METHODOLOGY
- Sample
Inclusion Criteria
Exclusion Criteria
Procedure
Institutional Review Board (IRB)Approval
- Data Analysis
Summary
4. RESULTS
- Introduction
Demographics
Significance
Trends of glucose levels
Hypoglycemia
Differences in Insulin Infusion Protocols 2002 and 2003
Summary
5. DISCUSSION
- Limitations
Implications for clinical practice
Implications for education
Recommendations for research
Conclusion
REFERENCES
APPENDICES
- APPENDIX A: Insulin Infusion Protocol 2002
APPENDIX B: Insulin Infusion Protocol 2003
APPENDIX C: Intensive Care Unit Manager Approval for Study
APPENDIX D: Institutional Review Board Exempt Approval
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