A PROSPECTIVE OBSERVATIONAL STUDY ON THE USE OF INSULIN INFUSION IN COMPLIANCE WITH STANDARD OPERATING PROCEDURES IN CARDIAC SURGERY AND MEDICAL INTENSIVE CARE UNITS

Robin Jose*, Alwin Jose, Rinto Paul Raju, Christy Sara Andrews, Soumya Shaji, Apollo James and Siva Kumar T.

ABSTRACT

Hyperglycemia is encountered as a major issue for increasing morbidity, mortality and length of stay in critically ill patients with or without the history of diabetes. A good control over the patient’s glucose level is essential for the improvement of patient outcome. For a tight glucose control, proper adherences with the standard operating procedures are very essential. The aim of the study was to determine the compliance of use of insulin infusion with standard operating procedures (SOPs) in cardiac surgery and medical intensive care units of a tertiary care hospital. The study was conducted in the intensive care unit for 3 months with 150 patients who were receiving insulin infusion. For this study, an insulin infusion safety protocol audit tool was prepared as per protocol, which includes the following parameters: initial Glucose Random Blood Sugar (GRBS) assessment, accuracy in Insulin dilution, Labelling of syringe infusion pump and administration of Insulin in increments according to patient need. The compliance of these parameters with the standard operating procedures was evaluated. At the end of the study a progressive improvement in the adherence to the standard operating procedures were observed. All medical practitioners must follow a standard insulin infusion protocol in a hospital. A daily auditing is very useful for ensuring the rational use of insulin.

Keywords: Hyper glycemia, diabetes mellitus, Insulin infusion, Standard operating procedures, Insulin algorithms, syringe infusion pumps.