Glycemic control after coronary bypass graft: using intravenous insulin regulated by a computerized system

Crit Care Nurs Clin North Am. 2006 Jun;18(2):257-65, xi. doi: 10.1016/j.ccell.2006.01.001.

Abstract

Hyperglycemia is a risk factor for poor outcomes in patients who undergo coronary artery bypass grafting. Poor outcomes led a multidisciplinary team to formulate a protocol to improve glycemic control of inpatients who had diabetes or hyperglycemia. This protocol initiated an intravenous (i.v.) insulin infusion that is regulated by a computerized system that is known as a Glucommander, and guides the surgeon and nurses to an easy transition to subcutaneous insulin. As a result of implementing the computerized system which regulated i.v. insulin, glycemic control improved during surgery and postoperatively. Additionally, physician and nurse satisfaction increased because of better glycemic control using a reliable, safe, and easy tool for the management of insulin infusions and there were fewer interruptive phone calls to physicians.

Publication types

  • Evaluation Study

MeSH terms

  • Algorithms
  • Attitude of Health Personnel
  • Clinical Nursing Research
  • Clinical Protocols
  • Coronary Artery Bypass / adverse effects*
  • Critical Care / methods
  • Drug Monitoring / methods*
  • Drug Monitoring / nursing
  • Drug Therapy, Computer-Assisted / instrumentation
  • Drug Therapy, Computer-Assisted / methods*
  • Equipment Design
  • Humans
  • Hyperglycemia / etiology
  • Hyperglycemia / prevention & control*
  • Hypoglycemic Agents / therapeutic use
  • Infusions, Intravenous
  • Injections, Subcutaneous
  • Insulin / therapeutic use
  • Insulin Infusion Systems* / statistics & numerical data
  • North Carolina
  • Nurse's Role
  • Nursing Assessment
  • Nursing Evaluation Research
  • Patient Care Team / organization & administration
  • Postoperative Care / methods
  • Postoperative Care / nursing
  • Risk Factors
  • Treatment Outcome

Substances

  • Hypoglycemic Agents
  • Insulin