Insulin Infusion Protocol
Objective:High blood sugar levels can be very serious, especially for high-risk patients. The clinical team at Kapi‘olani Medical Center at Pali Momi recognized the need to manage blood sugar levels for these high-risk patients and began working on this issue in 2004 with the goal of optimizing glycemic control in critically-ill patients.
Summary:Thirty-eight percent of hospitalized patients monitored for blood sugar have levels that are too high. Contrary to what many people think, not all of these patients are diabetic. In fact, 32% of them are not diabetic. High blood sugar levels during serious illness is associated with an increased risk for related complications and less than optimal outcomes.
The Intensive Care Unit team developed an Intravenous Insulin Infusion Protocol (IIP) which was designed to assist with maintaining a patient’s blood sugar levels in the target therapeutic range. When the project first began, we found that there were many patients that were not within the target range. Once the protocol was put in place, levels were more often within the appropriate range, resulting in better care for patients.
The changes have lead to a 38-percent reduction in the average blood glucose level of ICU patients. This decrease was statistically significant and has been maintained for more than two years, as you can see from the comparison below.
[Last updated 8/8/07]