Medical Staff Experience of an ICU Insulin Infusion Protocol

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 839-872-Diabetes & Obesity Management
Clinical
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-865
Queenie Guinto Ngalob*1, Cecilia A. Jimeno2 and Iris Thiele Isip-Tan2
1University of Philippines, Manila, Philippines, 2University of the Philippines, Manila, Philippines
Introduction.  The recommended strategy for glycemic control among critically ill is use of  intravenous insulin that is adjusted via a standardized insulin protocol. Critical to its successful implementation is acceptance of the implementing staff.   In our hospital, we adapted and modified the Yale Insulin infusion protocol to target the current blood glucose recommendations and tailor it to our hospital’s setting.   Evaluation of its performance in routine clinical practice specifically the medical staff experience  has not yet been done.

Objectives:   To evaluate medical staff experience and acceptance of the protocol through a survey.

 

Methods.  A survey followed by group discussions among the medical staff of the Medical and Central Intensive Care Units were done.  Questionnaires were distributed to the nurses of the two ICU units and the medical residents who manned in these ICUs.  The survey focused  on assessment of their experience and acceptance of the insulin protocol.  Group discussions were done after the survey to clarify  and confirm the information derived from the survey. 

 

Results.   A total of  109 medical staff (47 nurses and 62 medical residents) participated in the study. Majority (76.7%) of the ICU nurses felt that they had good knowledge of the IIP.  Seventy-sevent percent of nurses agree that the Modified Yale Insulin Infusion Protocol (IIP)  is effective in controlling hyperglycemia and 57.4% felt that it prevented hypoglycemia.   While 74.5% held that the protocol increases their workload due to frequent glucose checks and need for computations to adjust the drip, majority (64%) agree that it is easy to administer.  Seventy percent  of nurses are satisfied with the use of the protocol.  Similarly,  most (80.6%) medical residents in the ICUs believe that the IIP is effective.  While most felt that the protocol is not easy to administer (68%),  majority (64%)  would still opt to use it for their patients.  The staff believes that periodic training  and provision of supplies are key factors in improving the protocol.

Conclusion.  Experience and acceptance of the insulin infusion protocol is generally excellent for both nurses and physicians.  Despite an increase in workload, most believe the protocol to be effective and would advocate its use for ICU patients. 

Nothing to Disclose: QGN, CAJ, ITI

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm