ICU静脉输注胰岛素患者血糖管理的护理专案改善及其效果评价

发布时间：2018-07-31 14:58

【摘要】：目的运用护理专案改善方法对ICU静脉输注胰岛素患者的血糖管理进行持续质量改进,使重症患者在静脉输注胰岛素时安全、有效和平稳降糖。方法回顾性分析2014年上半年ICU静脉输注胰岛素患者低血糖发生率、血糖达标时间、胰岛素使用情况等,运用专案改善方法制订相应胰岛素输注和血糖监测质控方案,对2014年下半年ICU静脉输注胰岛素患者进行血糖管理,对比对照组(上半年)和干预组(下半年)患者低血糖发生率、血糖达标时间、胰岛素使用剂量、开始和停止胰岛素时血糖值。结果两组ICU静脉输注胰岛素患者低血糖发生率分别为10%和2%(P0.05);对照组和干预组患者平均一次静脉输注胰岛素期间血糖达标时间分别为(11.83±4.98)h和(10.15±5.34)h(P0.05);对照组和干预组患者平均一次静脉输注胰岛素的剂量平均秩为54.96和44.94(P0.05);对照组和干预组患者开始使用胰岛素时的血糖值分别为(18.70±3.70)mmol/L和(16.82±2.98)mmol/L(P0.05);对照组和干预组患者停止使用胰岛素时的血糖值分别为(8.80±2.20)mmol/L和(9.88±2.31)mmol/L(P0.05)。结论通过专案改善,可降低ICU静脉输注胰岛素患者的低血糖发生率,缩短血糖达标时间,减少胰岛素输注剂量,提高护士预防低血糖的风险意识。
[Abstract]:Objective to improve the continuous quality of blood glucose management in patients with ICU intravenous insulin infusion by using the method of nursing project improvement, so as to make the severe patients safe, effective and stable when intravenous insulin is infused. Methods the incidence of hypoglycemia, the time of meeting the standard of blood glucose, and the use of insulin in patients with ICU intravenous insulin infusion in the first half of 2014 were analyzed retrospectively. In the second half of 2014, blood glucose management was performed in patients with ICU intravenous insulin infusion. The incidence of hypoglycemia, the time of blood glucose reaching the standard, and the dosage of insulin were compared between the control group (in the first half of the year) and the intervention group in the second half year. Blood glucose levels at the start and stop of insulin. Results the incidence of hypoglycemia was 10% and 2% (P0.05) in patients with insulin intravenous infusion of ICU, and the average time of meeting the standard of blood glucose in control group and intervention group was (11.83 卤4.98) h and (10.15 卤5.34) h (), respectively, while that in control group and intervention group was (11.83 卤4.98) h and (10.15 卤5.34) h (), respectively. The blood glucose values of the control group and the intervention group were (18.70 卤3.70) mmol/L and (16.82 卤2.98) mmol/L (P0.05) respectively, and the blood glucose values of the control group and the intervention group were (8.80 卤2.20) mmol/L and (9.88 卤2.31) mmol/L (P0.05) respectively. Conclusion through special project improvement, the incidence of hypoglycemia, the time of blood glucose reaching the standard, the dosage of insulin infusion and the risk consciousness of nurses to prevent hypoglycemia can be reduced in patients with ICU intravenous insulin infusion.
【作者单位】：暨南大学附属第一医院ICU;
【基金】：广东省广州市天河区2014年科技计划项目(编号:201409KW035)
【分类号】：R473.5

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