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Updated: Jul 3, 2026

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
[Assessment of a nursing protocol for the management of hyperglicaemia in hospitalized patients]
Anna Vittoria Ciardullo1, Lorella Rossetti, Maria Monica Daghio
1Medicina Intena, Ospedale Ramazzini, AUSL, Modena.
Aim:
To assess the effectiveness of a nurse-led protocol for the management of hypo/ hyperglicaemia in a medical ward.
Methods:
Protocols for standard therapy, and parenteral intensive insulin therapy for severe hypo/hyperglycaemia in hospitalised patients were implemented.
Period:
march-november 2007.
Results:
189 patients (19%) were labelled as "hyperglycaemic" at admission in Emergency Department. Median (+/-IQR) age was 77 (70-84) years, 41% were men, with known diabetes 74%, 18% had skin ulcers. Median glycaemia at admission was 144.5 (98-220) mg/dl. Thirty-six percent of patients was euglycaemic (60-126 mg/dl), 3% hypoglycaemic (<60 mg/dl). The glicaemic values ranged from 127-140 mg/dl (9% patients), from 141-280 mg/dl, (40%patients) and > 280 mg/dl (12% patients). The glicaemic values of the 14 patients requiring the intravenous intensive insulin regimen remained in a safe range (80-250 mg/dl) in the first 15 hours from the infusion start. No patient experienced a life-threatening hypoglycaemia nor hypoglycaemic coma. After three days on standard therapy, glicaemic levels were acceptable: 142 (98-185) pre-breakfast, 144(107-200) pre-lunch, 131 (102-190) pre-dinner, 183 (123-230) mg/dl postprandial.
Conclusion:
Data showed the effectiveness and safety of a nurse-led protocol for the care of hyperglicaemia in a medical ward.
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