Sliding Scale Insulin Dose Delivery And Meal Time In Acute Care Patients - NUR 102 - Research Article Summary

Running head: RELATIONSHIP OF GLUCOSE VALUES TO INSULIN DOSE DELIVERY 1
RELATIONSHIP OF GLUCOSE VALUES TO INSULIN DOSE DELIVERY 2
Relationship of Glucose Values to Sliding Scale Insulin (Correctional Insulin) Dose Delivery and Meal Time in Acute Care Patients with Diabetes Mellitus
Relationship of Glucose Values to Sliding Scale Insulin (Correctional Insulin) Dose Delivery and Meal Time in Acute Care Patients with Diabetes Mellitus
Article Summary
Diabetes Mellitus type 1 and type 2 effect approximately 30.3 million Americans, which is 9.4% of the U.S. population. It is estimated that 30 percent of hospitalized patients have either type 1 or type 2 diabetes mellitus, therefore managing the blood glucose levels of these patients is a critical part of inpatient diabetes management. The article “Relationship of Glucose Values to Sliding Scale Insulin (Correction Insulin) Dose Delivery and Meal time in Acute Care Patients with Diabetes Mellitus”, (Trotter, Conaway, & Burns, 2013), explores methods of glucose level management and insulin administration on adult acute care and critical care units. The authors of this article conducted a comprehensive literature review and following that a study to determine if the current standard glycemic management approach of using sliding scale insulin (SSI) is effective in improving target glucose values among adult medical. They hypothesized that " Pre-prandial point-of-care fingerstick glucose results obtained more than 30 minutes before the meal will demonstrate a variation in glucose values that is not consistent with insulin dosing regimens", (Totter et al., 2013, p.100). This research is important and relevant to the nursing profession, for the reason that patient outcomes will be improved if inpatient diabetes management is guided by evidenced based practice. Hyperglycemia is linked to adverse patient outcomes, such as increased length of hospital stays, increased risk of infections, and mortality. Evidence based practice will allow nurses to make clinical decisions based upon research, which will guide their use of the nursing process.
Article Description
The authors of this article note that in recent years professional guidelines for inpatient diabetes management has evolved to include basal/ nutritional/ correctional insulin methods for patients on acute care units, and continuous infusion of insulin in patients on critical care units. Basal insulin is long acting, nutritional insulin in rapid acting and administered before meals, and correctional insulin is rapid acting and given in response to high blood glucose. Although these are the recommended methods, the authors found that sliding scale insulin is still being used today as a stand-alone treatment, with that in mind they decided to focus their study solely on sliding scale insulin administration.
Through the comprehensive literature review of CINAHL and Medline for the years 2005-2012 using the search words: diabetes, adult, insulin, ...