Endocrine Abstracts

Introduction: The recommended strategy for glycemic control among critically ill is i.v. insulin adjusted via a standardized insulin protocol. Critical to its success is acceptance of the implementing staff. In our hospital, we adapted and modified the Yale insulin infusion protocol (IIP). Evaluation of medical staff experience has not yet been done.

Objectives: To evaluate medical staff experience and acceptance of the IIP through a survey and focused group discussion.

Methods: A survey followed by focused group discussions among the medical staff of the Medical and Central Intensive Care Units were done. Questionnaires were distributed to the nurses and medical residents of ICUs. Focused group discussions were done after to clarify the information derived from the survey.

Results: One hundred nine medical staff (47 nurses and 62 medical residents) participated in the study. Majority (76.7%) of ICU nurses felt they had good knowledge of the IIP. Seventy-seven percent of nurses agree that the IIP is effective in controlling hyperglycemia and 57.4% felt that it prevented hypoglycemia. While 74.5% held that the protocol increases their workload due to frequent glucose checks and need for computations to adjust the drip, majority (64%) agree that it is easy to administer. Seventy percent of nurses are satisfied with the use of the protocol. Similarly, most (80.6%) medical residents in the ICUs believe that the IIP is effective. While most felt that the protocol is not easy to administer (68%), majority (64%) would still opt to use it for their patients. The staff believes that periodic training and provision of supplies are key factors in improving the protocol.

Conclusion: Experience and acceptance of the insulin infusion protocol is generally excellent for both nurses and physicians. Despite an increase in workload, most believe the protocol to be effective and would advocate its use for ICU patients.