Related Experiment Video
Updated: May 21, 2026
12:08
Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Evaluating an insulin infusion protocol in an acute care setting.
Christy Locke1, Judy McEuen, Robert S Felder
1Portland Veterans Affairs (VA) Medical Center, Oregon, USA. christine.locke@va.gov
Clinical Nurse Specialist CNS
|June 2, 2012
Summary
Both paper and electronic insulin infusion protocols show adherence in medical-surgical settings. Electronic protocols offer improved nurse workload and safety benefits.
Area of Science:
- Medical-surgical nursing
- Pharmacology
- Health informatics
Background:
- Insulin infusion protocols are critical for managing blood glucose levels in surgical patients.
- Traditional paper-based protocols may present challenges in accuracy and efficiency.
Purpose of the Study:
- To compare the adherence, safety, and effectiveness of paper versus electronic insulin infusion protocols.
- To evaluate the impact of electronic protocols on nurse workload and perceived ease of use.
Main Methods:
- A quasi-experimental implementation study with a nonrandomized prospective cohort design.
- Involved 58 registered nurses across two surgical units in a tertiary care teaching hospital.
- Measured adherence through electronic time stamps and nurse surveys; assessed safety by reviewing paper protocol calculation accuracy.
Main Results:
- No significant difference in adherence or time intervals between paper and electronic protocols.
- Paper protocols had a 10.7% calculation error rate.
- Nurses using electronic protocols reported significantly greater ease in balancing workload.
Conclusions:
- Insulin infusion protocols are achievable regardless of format in medical-surgical settings.
- Electronic insulin infusion protocols demonstrate potential safety and nurse workload advantages.
Related Concept Videos
01:16Insulin: Dosing Regimen and Adverse Effects
Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
01:27Insulin Formulations: Types and Delivery
Insulin preparations are categorized by their duration of action into short-acting and long-acting types. Two strategies are used to modify insulin's absorption and pharmacokinetic profile: slowing the absorption post-subcutaneous injection, or altering human insulin's amino acid sequence or protein structure. These changes retain the insulin's ability to bind to the insulin receptor, but alter its behavior in solution or after injection.
Short-acting insulins are divided into rapid-acting...
Short-acting insulins are divided into rapid-acting...
01:15Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations
Gentamicin, an aminoglycoside antibiotic, is commonly administered via intermittent intravenous infusion to treat severe infections. An intermittent one-hour infusion of gentamicin, administered at eight-hour intervals, allows for precise control of plasma drug concentrations, minimizing toxicity while ensuring therapeutic efficacy. Pharmacokinetic principles govern the dynamics of plasma concentrations and can be mathematically described using specific equations.The plasma drug concentration...
01:24Drug Accumulation During Multiple Dosing: Intermittent IV Infusions
Intermittent intravenous (IV) infusion is a method of drug administration where medications are delivered over short infusion periods followed by intervals of no drug delivery. This approach helps to prevent sustained high drug concentrations in the bloodstream, reducing the risk of adverse effects associated with prolonged exposure. Unlike continuous infusion, steady-state concentrations may not be achieved during a single dosing cycle but can be reached through repeated...
01:28IV Infusion to Oral Dosing: Conversion Methods
The development of extended-release formulations has facilitated the transition from intravenous to oral medication, offering a more convenient and patient-friendly approach to drug administration. This transition, however, requires careful management to ensure that therapeutic drug levels are maintained, preserving efficacy and avoiding adverse effects. Understanding pharmacokinetic principles and dosage calculations is critical during this process.Pharmacokinetics of the...
01:20Acute Kidney Injury V: Interprofessional Care
Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...