Correct identification and prescribing of variable rate intravenous infusion of insulin in patients with hyperglycaemia
- What is the most reliable point to prescribe variable rate intravenous infusion of insulin (VRIII) and by whom?
- Can the prescription be standardised or preprinted to minimise prescribing errors?
- How can the plan be communicated most accurately throughout their critical care stay?
- How can the plan for termination of VRIII or the switch to another form of insulin be communicated to and carried out accurately by the nursing staff?
Correct monitoring of blood glucose:
- Look at the documented blood glucose levels from admission to discharge from critical care.
- Look for parts where the glucose monitoring is often missed or fails to meet the recommended frequency standard. Are there any patterns? Which members of staff are present at this point? How can they be prompted to measure glucose appropriately?
Compliance with set blood glucose targets
- Was hyperglycaemia correctly identified and managed? Consider adding to checklist of daily goals process. Consider use of measurement and run charts to inform compliance levels with set targets.
