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Updated: Jul 17, 2026

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Implementing an intravenous insulin infusion protocol in the intensive care unit
Rhonda S Rea1, Amy Calabrese Donihi, MaryBeth Bobeck
1Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, PA 15213, USA. rears@msx.upmc.edu
Implementing intravenous insulin protocols in intensive care units (ICUs) requires multidisciplinary collaboration and pharmacist support. Successful adoption involves continuous staff education and protocol flexibility for improved patient glycemic control.
Area of Science:
- Critical Care Medicine
- Endocrinology
- Hospital Pharmacy
Background:
- Tight glycemic control in intensive care units (ICUs) is associated with improved patient outcomes.
- Intravenous insulin protocols are crucial for managing hyperglycemia in critically ill patients.
- Implementing new protocols in hospital settings presents unique challenges.
Purpose of the Study:
- To describe the implementation of three distinct intravenous insulin protocols across two community hospitals and one academic hospital.
- To identify factors influencing protocol adoption and challenges encountered during implementation.
- To compare protocol implementation differences between academic and community hospital settings.
Main Methods:
- The study involved the implementation of three different intravenous insulin protocols in ICU settings.
- Data collection likely involved process measures, staff feedback, and compliance monitoring.
- A comparative analysis was performed between academic and community hospital implementations.
Main Results:
- All three institutions successfully implemented i.v. insulin infusion protocols, achieving physician and nurse acceptance and compliance.
- Obstacles included increased staff workload, algorithm complexity, and perceived lack of benefit.
- Differences in implementation were influenced by institutional type, physician response, protocol details, and nursing autonomy.
Conclusions:
- Successful insulin protocol implementation in ICUs is facilitated by multidisciplinary involvement, continuous nursing education, dedicated pharmacist support, and protocol adaptability.
- A full-time dedicated ICU pharmacist is recommended for multidisciplinary rounds, nursing support, and process measure collection.
- Institutional commitment to refining insulin protocols is key to achieving tighter glycemic control and improving patient outcomes.
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