Trial Protocol Analysis of Nursing Workload Intensity within ICU

Currently, effective glycaemic control protocols consume significant nursing time, which may be unsustainable as the number of patients requiring control increases with increasing rates of diabetes. This paper investigates the safety and efficacy of basal insulin therapy as a means to reduce nurse w...

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Main Authors: N. N., Razak, A. A., Razak, C. G., Pretty, N. H., Ahamad, F. M., Suhaimi, Ummu Kulthum, Jamaludin
Other Authors: Fatimah, Ibrahim
Format: Book Chapter
Language:English
Published: Springer 2016
Subjects:
Online Access:http://umpir.ump.edu.my/id/eprint/6765/1/Trial%20Protocol%20Analysis%20of%20Nursing%20Workload%20Intensity%20within%20ICU.pdf
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author N. N., Razak
A. A., Razak
C. G., Pretty
N. H., Ahamad
F. M., Suhaimi
Ummu Kulthum, Jamaludin
author2 Fatimah, Ibrahim
author_facet Fatimah, Ibrahim
N. N., Razak
A. A., Razak
C. G., Pretty
N. H., Ahamad
F. M., Suhaimi
Ummu Kulthum, Jamaludin
author_sort N. N., Razak
collection UMP
description Currently, effective glycaemic control protocols consume significant nursing time, which may be unsustainable as the number of patients requiring control increases with increasing rates of diabetes. This paper investigates the safety and efficacy of basal insulin therapy as a means to reduce nurse workload associated with glycaemic control in intensive care patients with stress hyperglycaemia. Validated virtual trial simulations (N = 40 patients) of a successful glycaemic control protocol (SPRINT) using 1-2 hourly interventions and a modified version using 4 hour interventions augmented with basal insulin therapy using Glargine. An additional model was used to capture the kinetics of Glargine. Workload was assessed by counting the total number of interventions (BG measurements, changes to insulin and nutrition rates) per day. Glycaemic performance was assessed by time in the target band (4.4-7.0 mmol/L) and number of severe hypoglycaemic episodes (BG<2.2 mmol/L). Workload reduction is around 30% (p<0.001) due to basal insulin therapy. Glycaemic control performance was slightly reduced from 86% to 80% (p=0.006) time in the target band using basal insulin therapy and 4 hourly interventions. However, safety was maintained with 0 incidence hypoglycaemia. Basal insulin therapy enables glycaemic control protocols with reduced intervention frequency while maintaining performance and safety. Reduced intervention frequency directly translates into reduced nurse workload associated with glycaemic control.
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spelling UMPir67652018-11-30T02:00:55Z http://umpir.ump.edu.my/id/eprint/6765/ Trial Protocol Analysis of Nursing Workload Intensity within ICU N. N., Razak A. A., Razak C. G., Pretty N. H., Ahamad F. M., Suhaimi Ummu Kulthum, Jamaludin TJ Mechanical engineering and machinery Currently, effective glycaemic control protocols consume significant nursing time, which may be unsustainable as the number of patients requiring control increases with increasing rates of diabetes. This paper investigates the safety and efficacy of basal insulin therapy as a means to reduce nurse workload associated with glycaemic control in intensive care patients with stress hyperglycaemia. Validated virtual trial simulations (N = 40 patients) of a successful glycaemic control protocol (SPRINT) using 1-2 hourly interventions and a modified version using 4 hour interventions augmented with basal insulin therapy using Glargine. An additional model was used to capture the kinetics of Glargine. Workload was assessed by counting the total number of interventions (BG measurements, changes to insulin and nutrition rates) per day. Glycaemic performance was assessed by time in the target band (4.4-7.0 mmol/L) and number of severe hypoglycaemic episodes (BG<2.2 mmol/L). Workload reduction is around 30% (p<0.001) due to basal insulin therapy. Glycaemic control performance was slightly reduced from 86% to 80% (p=0.006) time in the target band using basal insulin therapy and 4 hourly interventions. However, safety was maintained with 0 incidence hypoglycaemia. Basal insulin therapy enables glycaemic control protocols with reduced intervention frequency while maintaining performance and safety. Reduced intervention frequency directly translates into reduced nurse workload associated with glycaemic control. Springer Fatimah, Ibrahim Juliana, Usman Mas Sahidayana, Mokhtar Mohd Yazed, Ahmad 2016 Book Chapter PeerReviewed application/pdf en http://umpir.ump.edu.my/id/eprint/6765/1/Trial%20Protocol%20Analysis%20of%20Nursing%20Workload%20Intensity%20within%20ICU.pdf N. N., Razak and A. A., Razak and C. G., Pretty and N. H., Ahamad and F. M., Suhaimi and Ummu Kulthum, Jamaludin (2016) Trial Protocol Analysis of Nursing Workload Intensity within ICU. In: International Conference for Innovation in Biomedical Engineering and Life Sciences. IFMBE Proceedings, 56 . Springer, Singapore, pp. 294-297. ISBN 978-981-10-0265-6 (Print); 978-981-10-0266-3 (Online) http://dx.doi.org/10.1007/978-981-10-0266-3_62 DOI: 10.1007/978-981-10-0266-3_62
spellingShingle TJ Mechanical engineering and machinery
N. N., Razak
A. A., Razak
C. G., Pretty
N. H., Ahamad
F. M., Suhaimi
Ummu Kulthum, Jamaludin
Trial Protocol Analysis of Nursing Workload Intensity within ICU
title Trial Protocol Analysis of Nursing Workload Intensity within ICU
title_full Trial Protocol Analysis of Nursing Workload Intensity within ICU
title_fullStr Trial Protocol Analysis of Nursing Workload Intensity within ICU
title_full_unstemmed Trial Protocol Analysis of Nursing Workload Intensity within ICU
title_short Trial Protocol Analysis of Nursing Workload Intensity within ICU
title_sort trial protocol analysis of nursing workload intensity within icu
topic TJ Mechanical engineering and machinery
url http://umpir.ump.edu.my/id/eprint/6765/1/Trial%20Protocol%20Analysis%20of%20Nursing%20Workload%20Intensity%20within%20ICU.pdf
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