Implementation of an Evidence‐Based Protocol for Blood Glucose Management in Critically Ill Adult Patients: A Pilot Study.

Background: Critically ill patients are prone to stress hyperglycaemia, which can negatively impact clinical outcomes at high blood glucose levels. Evidence‐based blood glucose management practices to improve patient outcomes should be explored. Aim: This pilot study aimed to implement an evidence‐b...

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Publicado en:Nursing in Critical Care Vol. 30; no. 4; pp. 1 - 15
Autores principales: Huang, Miao, Li, Dongxue, Zhang, Chuanlai, Yang, Ruiqi, Bai, Xue, Gan, Xiuni
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Jul2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jul2025
      vid: 30
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: Implementation of an Evidence‐Based Protocol for Blood Glucose Management in Critically Ill Adult Patients: A Pilot Study.
      aug:
        au:
          Huang, Miao
          Li, Dongxue
          Zhang, Chuanlai
          Yang, Ruiqi
          Bai, Xue
          Gan, Xiuni
        affil: Department of Nursing, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
      sug:
        subj:
          Critically Ill Patients Psychosocial Factors
          Blood Glucose Analysis
          Protocols
          Implementation Science
          Critical Illness Nursing
          Glycemic Control Standards
          Hyperglycemia
          Intensive Care Units
          Treatment Outcomes
          Attitude to Health
          Human
          Funding Source
          Male
          Female
          Adult
          Middle Age
          Aged
          Pilot Studies
          Critical Care Nursing Psychosocial Factors
          Critical Care
          Questionnaires
          Clinical Competence
          Health Personnel Psychosocial Factors
          Workflow
          Descriptive Statistics
          Comparative Studies
          Quasi-Experimental Studies
          Confidence Intervals
          Data Analysis Software
          Chi Square Test
          Caregivers Psychosocial Factors
          Nurse Attitudes
          China
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Background: Critically ill patients are prone to stress hyperglycaemia, which can negatively impact clinical outcomes at high blood glucose levels. Evidence‐based blood glucose management practices to improve patient outcomes should be explored. Aim: This pilot study aimed to implement an evidence‐based glycaemic management protocol for critically ill adults and assess its impact on ICU nurses' knowledge, attitudes, behaviours as well as healthcare professionals' adherence and patient outcomes. Study Design: This quasi‐experimental study included a controlled pre‐post pilot study that was conducted from April to June 2023 in a general ICU. An evidence‐based glycaemic management protocol was developed for critically ill adults using the Rosswurm and Larrabee model for evidence‐based practice change. The study cohort ultimately comprised 48 ICU nurses who completed both pre‐ and post‐implementation surveys and 61 patients (control group, 34; intervention group, 27). ICU nurses' knowledge, attitudes and behaviours; healthcare providers' compliance; and patients' clinical outcomes were measured to assess the effectiveness of the intervention. Results: After implementing the intervention, ICU nurses' knowledge, attitudes and behaviours toward glycaemic management significantly improved. Among the 38 indicators of healthcare providers' compliance, 12 showed a 0%–100% improvement rate post‐implementation and 8 showed a compliance rate increase of 5.9%–66.7%. Statistically significant improvements were found in the duration of hyperglycaemia (t = 2.841, p < 0.05, 95% CI [4.15, 24.46]), time to reach target glucose levels (t = −2.215, p < 0.05, 95% CI [−12.02, −0.61]) and rate of complications (χ2 = 4.325, p < 0.05) among patients. Conclusions: The evidence‐based glycaemic management protocol for critically ill adults is feasible and effective for clinical use. The Rosswurm and Larrabee model was useful for guiding the implementation of the protocol in mainland China. Relevance to Clinical Practice: This pilot study provides a reference for blood glucose management in critically ill patients. Through structured training and procedural refinements, it facilitated the optimization of clinical workflows for glycaemic control, promoting a paradigm shift from experience‐based to evidence‐driven nursing practices among ICU nurses.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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