Computerisation of a paper-based intravenous insulin protocol reduces errors in a prospective crossover simulated...

Area of Science:

• Critical Care Medicine
• Clinical Pharmacy
• Nursing Informatics

Background:

• Paper-based insulin protocols for tight glycaemic control (TGC) are complex and error-prone.
• Understanding errors from misinterpretation and the impact of computerised protocols is limited.

Purpose of the Study:

• Compare errors from protocol misinterpretation between computerised and paper-based insulin protocols.
• Evaluate time required for insulin infusion management.
• Assess nursing satisfaction with both protocol types.

Main Methods:

• A crossover study involving 62 ICU nurses.
• Completion of 10 simulated TGC scenarios for both computerised and paper protocols.
• Evaluation of insulin management phases: initiation, titration, and transition, examining errors, time, and satisfaction.

Main Results:

• Computerised protocols led to higher nurse satisfaction.
• Significant reduction in titration (13 vs. 113 errors) and transition (9 vs. 23 errors) phase errors.
• Less time to complete titration phase (6 vs. 9.5 min) with computerised protocols.

Conclusions:

• Computerised TGC protocols significantly reduce insulin dosing errors in simulated environments.
• Computerised protocols improve efficiency by saving time in insulin management.
• Enhanced nurse satisfaction observed with computerised insulin protocols.