IDEAS home Printed from https://ideas.repec.org/a/wly/jocnur/v25y2016i19-20p3001-3009.html
   My bibliography  Save this article

Low‐dose intensive insulin therapy in patients with Acute Coronary Syndrome accompanied by Left Ventricular Failure: audit of two UK hospitals

Author

Listed:
  • Nicola Manning
  • John W Albarran

Abstract

Aims and Objectives To determine whether a low‐dose intravenous insulin regimen reduces blood glucose levels at a timely rate and associated side effects among patients with Acute Coronary Syndrome and Left Ventricular Failure. Background Induced hypoglycaemia and the associated risks have questioned the benefits of intensive insulin therapy in patients presenting with raised blood glucose levels and Acute Coronary Syndromes. Local audit data identified that patients with Acute Coronary Syndrome and Left Ventricular Failure experienced more hypoglycaemic episodes than those with Acute Coronary Syndrome alone. Consequently, a new regimen of low‐dose insulin for this group was implemented and audited over 12 months. Design Audit. Methods Thirty‐six consecutive patient notes with a diagnosis of Acute Coronary Syndrome and blood glucose of ≥10 mmol/l treated with a new insulin therapy regimen were analysed. Data were extracted using a standardised form and entered into an Excel spreadsheet for analysis. Results The mean age of the sample was 70 years with 66% of subjects being men and 50% presenting with Acute Coronary Syndrome and Left Ventricular Failure. The low‐dose regimen was effective in achieving normoglycaemia, (range 4–8 mmol/l) for a consecutive six‐hour period. This was achieved in 72% of patients and within a median time of 13 hours. Conclusion The audit suggests that a low‐dose insulin regimen can effectively stabilise blood glucose in patients presenting with both Acute Coronary Syndrome and Left Ventricular Failure. The importance of regularly monitoring blood sugar levels is vital and highlights the role of nurses in minimising patient risk and promoting safety. Relevance to practice Nurses are instrumental in the safe implementation of intensive insulin guidelines. Close monitoring of patients is essential, enabling timely adjustments to treatments and ensuring patient safety. Regular audits allow nurses to evaluate care provision and continue to drive practice forward.

Suggested Citation

  • Nicola Manning & John W Albarran, 2016. "Low‐dose intensive insulin therapy in patients with Acute Coronary Syndrome accompanied by Left Ventricular Failure: audit of two UK hospitals," Journal of Clinical Nursing, John Wiley & Sons, vol. 25(19-20), pages 3001-3009, October.
  • Handle: RePEc:wly:jocnur:v:25:y:2016:i:19-20:p:3001-3009
    DOI: 10.1111/jocn.13257
    as

    Download full text from publisher

    File URL: https://doi.org/10.1111/jocn.13257
    Download Restriction: no

    File URL: https://libkey.io/10.1111/jocn.13257?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Serena Knowles & Elizabeth McInnes & Doug Elliott & Jennifer Hardy & Sandy Middleton, 2014. "Evaluation of the implementation of a bowel management protocol in intensive care: effect on clinician practices and patient outcomes," Journal of Clinical Nursing, John Wiley & Sons, vol. 23(5-6), pages 716-730, March.
    2. Saima Hinno & Pirjo Partanen & Katri Vehviläinen‐Julkunen, 2012. "Nursing activities, nurse staffing and adverse patient outcomes as perceived by hospital nurses," Journal of Clinical Nursing, John Wiley & Sons, vol. 21(11‐12), pages 1584-1593, June.
    3. Sandy Middleton, 2012. "Editorial: Keeping it simple: the power of three clinical protocols," Journal of Clinical Nursing, John Wiley & Sons, vol. 21(21-22), pages 3195-3197, November.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Kaisa Kinnunen‐Luovi & Reetta Saarnio & Arja Isola, 2014. "Safety incidents involving confused and forgetful older patients in a specialised care setting – analysis of the safety incidents reported to the HaiPro reporting system," Journal of Clinical Nursing, John Wiley & Sons, vol. 23(17-18), pages 2442-2450, September.
    2. Marja Härkänen & Susanna Saano & Katri Vehviläinen‐Julkunen, 2017. "Using incident reports to inform the prevention of medication administration errors," Journal of Clinical Nursing, John Wiley & Sons, vol. 26(21-22), pages 3486-3499, November.
    3. Dawn Warren & Bridie Kent, 2019. "Determining the impact of a bowel management protocol on patients and clinicians' compliance in cardiac intensive care: A mixed‐methods approach," Journal of Clinical Nursing, John Wiley & Sons, vol. 28(1-2), pages 89-103, January.
    4. Hye Yon Yu & Eun Kyoung Ahn & Eun Ji Seo, 2019. "Relationship between the frequency of nursing activities and adverse outcomes in patients with acute coronary syndrome: A retrospective cohort study," Nursing & Health Sciences, John Wiley & Sons, vol. 21(4), pages 531-537, December.
    5. Sujin Shin & Jin‐Hwa Park & Sung‐Heui Bae, 2019. "Nurse staffing and hospital‐acquired conditions: A systematic review," Journal of Clinical Nursing, John Wiley & Sons, vol. 28(23-24), pages 4264-4275, December.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:jocnur:v:25:y:2016:i:19-20:p:3001-3009. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: https://doi.org/10.1111/(ISSN)1365-2702 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.