Effectiveness of blood glucose control protocol for open heart surgery patients

Abstract

Aims To evaluate the effectiveness of a tailored blood glucose control protocol for postoperative cardiac surgery patients treated in intensive care. Design Retrospective study. Methods Data for the control group (non‐tailored protocol) were collected from medical records at a tertiary hospital in Seoul, Korea between April–July 2015. Data for the experimental group (tailored protocol) were obtained from medical records between April–July 2016. After adjusting the target blood glucose range, eliminating single‐dose insulin administration and extending the blood glucose measurement time interval, data for blood glucose measurements, time for reaching and maintaining target blood glucose, mean number of daily blood glucose measurements and insulin dose adjustments for the experimental group were collected. Results In the experimental group (where the target blood glucose rate was increased) the hypoglycaemia rate and the variation in blood glucose decreased significantly compared with the control group. In particular, the experimental group maintained relatively stable blood glucose levels by retaining a small variation range in glucose, regardless of the presence of diabetes. Time required for maintaining target blood glucose, mean number of daily blood glucose measurements and insulin dose adjustments per patient decreased. Conclusion The tailored protocol contributes to the safe and effective control of blood glucose in critical care patients after cardiac surgery and to the efficiency of nurses administering it. Impact This study has two significant impacts. The application of the tailored protocol has a positive impact on patients’ blood glucose management, a critical component of treatment for postoperative cardiac patients in intensive care units. It also has a positive impact on the efficiency of nurses applying it. The results of this study are thus expected to facilitate successful implementation of clinical protocols for critical care after heart surgery.

Glucose management in critically ill adults: A qualitative study from the experiences of health care providers

“…Many studies have confirmed the facilitating role of leadership in the process of ICU program implementation and quality improvement [ 45 ]. However, in the process of IIP implementation, researchers seem to pay more attention to the achievement of target blood glucose and the occurrence of complications [ 13 , 33 ]. Few studies have mentioned the role of leadership.…”

“…Therefore, the perceptions of healthcare professionals in the ICU about glucose management have a direct impact on the effectiveness of glucose management in critically ill patients. However, more studies have tended to explore the development of IIPs and the effectiveness of glycaemic control [ 13 , 14 ], few studies have focused on this.…”