The Construction of an Effective Glycemic Protocol in the Control of Hypoglycemia in ICU  - Systematic Literature Review

Catia Fonseca do Nascimento Pereira, Isabel Cristina Fonseca da Cruz

Abstract


A hypoglycemic event in an adult, especially the elderly, can lead to a series of complications linked to increased morbidity and mortality of the patient. In a hospital unit, the nurse is in the front line in the evaluation of the elderly regarding the risk of hypoglycaemia. The objectives of this study are to review the evidence-based guidelines that will assist the intensivist nurse in the identification, treatment, and conduct of nursing care related to the Control of Hypoglycemia. To do this, the methodology of integrative review of the literature will be used through the search of a virtual computerized database of articles available in the period between 2011 to 2017. The search was performed according to the PICO strategy and the articles were classified according to levels of evidence and clinical relevance. The study aimed to answer the clinical question: How effective is the control of hypoglycemia in reducing complications in hospitalized diabetic patients? Among the results were identified factors related to hypoglycemia, analysis and comparison of glycemic protocols and the role of nursing in the management of patients with diabetes.

Keywords


Critical care; diabetes complications; hypoglycemia; nursing care; glycemic controlnsulin, Intravenous Ifusions, Nursing Care, Intensive Care Unit.

Full Text:

HTML

References


Silverthorn DU. Fisiologia Humana: uma abordagem integrada. 5ª Ed. Porto Alegre: Artmed, 2010. p.742

Smeltzer SC, Bare BG. Brunner & Suddarth: Tratado de Enfermagem Médico-Cirúrgica. 12 ed. Rio de Janeiro: Guanabara Koogan, 2012. vol. I. cap. 37.

Paixão CT, Silva LD, Doerzapff PB, Granadeiro RMA, Farias RLA, Santos SS. Fatores de risco para hipoglicemia em pacientes que usam infusão contínua de insulina endovenosa na unidade de terapia intensiva. ABCS Health Sci. 2014; 39(3):194-198

Sanchez PBD, Cruz ICF. Journal of specialized nursing care. [periódico na internet] 2011 [acesso em 13.abr.2017]; 4(1). Disponível em http://www.uff.br/jsncare/index.php/jsncare/rt/printerFriendly/2346/524

Bulechek GM, Butcher HK, Dochterman JM. Classificação das intervenções de enfermagem – NIC. 5ª ed. Rio de Janeiro: Elsevier, 2010. p. 448.

Moorhead S, Johnson M, Maas ML, Swanson E. Classificação dos Resultados de enfermagem – NOC. 4 ed. Rio de Janeiro: Elsevier, 2010. p. 598.

Ballin MC. Hypoglycemia: a serious complication for the older adult with diabetes. AJN The American Journal of Nursing 2016; 116(2): 34-39.

Mendes KDS, Silveira RCCP, Galvão CM. Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto & contexto enfermagem 2008; 17(4):102-106. Disponível em http://www.scielo.br/pdf/tce/v17n4/18.pdf Acessado em jul.2017.

Santos CMC, Pimenta CAM, Nobre MRC. A estratégia PICO para a construção da pergunta de pesquisa e busca de evidências. Rev Latino-am Enfermagem, São Paulo [internet], 15(3), maio-jun. 2007 [acesso em 15.jul.2017]. Disponível em http://www.scielo.br/scielo.php?pid=S0104-11692007000300023&script=sci_arttext&tlng=pt

Medeiros LR, Stein A. Níveis de evidência e graus de recomendação da medicina baseada em evidências. [internet]Revista AMRIGS, Porto Alegre. 2002[acesso em 15.jul.2017]; 46 (1,2): 43-46. Disponível em http://www.amrigs.org.br/revista/46-01-02/N%C3%ADveis%20de%20evid%C3%AAncia%20e%20graus%20de%20recomenda%C3%A7%C3%A3o%20da%20medicina%20baseada%20em%20evid%C3%AAncias.pdf

Gartemann J, Caffrey E, Hadker N, Crean S, Creed GM, Rausch C. Nurse workload in implementing a tight glycaemic control protocol in a UK hospital: a pilot time-in-motion Study. British Association of Critical Care Nurses, 2012; 17(6): 279-84.

Paixão CT, Nepomuceno RM, Santos MM, Silva LD. Fatores predisponentes para hipoglicemia: aumentando a segurança do paciente crítico que utiliza insulina intravenosa. Rev enferm UERJ, Rio de Janeiro, 2015 jan/fev; 23(1):70-5.

Brady V. Management of Hyperglycemia in the Intensive Care Unit When Glucose Reaches Critical Levels. Critical Care Nursing Clinics of North America 2013, 25: 7–13.

Crespo JCL Gomes VR Barbosa RL Padilha KG Secoli SR. Haemodialysis, nutritional disorders and hypoglycaemia in critical care. British Journal of Nursing, 2017; 26 (5): 281-8.

Compton F, Ahlborn R, Weidehoff T. Nurse-Directed Blood Glucose Management in a Medical Intensive Care Unit. Critical Care Nurse, june 2017, 37 (3): 30-41.

Coats, A., Marshall, D. Inpatient hypoglycaemia: A study of nursing management. Nursing Praxis in NewZeaiand,2013, 29(2), 15-24.

Robb A, Reid B, Laird E A. Insulin nowledge and practice: a survey of district nurses in Northern Ireland. British Journal of Community Nursing. March, 2017, 22 (3):138-45.

Khalaila R et al. Nurse-Led Implementation of a Safe and Effective Intravenous Insulin Protocol in a Medical Intensive Care Uni. Critical Care Nurse, December, 2011, 31 (6): 27-35.

Oldroyd J. Care implications of the NICE quality standard for diabetes. Practice Nursing, 2011, 22 (08): 417-22.

Hargraves JD. Glycemic Control in cardiac surgery: Implementing na evidence-based insulin infusion protocol. American Associationl of Critical-Care nursing, May 2014, 23 (3): 250 – 259.






JSNCARE
Share |