Authors

1Ana Leticia Algaba Andrade, 1Laura Cazorla López, 1Carmen Ballesteros Plata

Position

¹Enfermeras de UCI. Hospital General del Hospital Universitario Virgen del Rocío. Sevilla.

Contact address

Ana Leticia Algaba Andrade. Avda. Ildefonso Marañón Lavín, 12, esc. 1, 6º F. 41019 Sevilla.

Contact email: analeticia3@hotmail.com

Abstract

Objective: critical patients tend to present hyperglycemia, a fact associated with an increase in morbimortality and infectious complications. According to the Spanish Society of Intensive and Critical Medicine and Coronary Units (SEMICYUC), a safe and good-quality care requires maintaining glycemic levels between 80 and 150 mg/dl with insulin therapy.
The objective is to obtain an estimation of the adequate maintenance of glycemic levels of patients, as well as to detect any potential for quality improvement, if necessary.
Method: a descriptive observational study conducted in the Intensive Care Unit of the Hospital Virgen del Rocío during January, February and March, 2014. The sample size was estimated in 108 patients, recruited in 13 days randomly chosen, with all week days represented. The indicator was measured according to the following formula: (Number of patients with glycemia > 150 mg/dl and on insulin treatment / Number of patients with indication for glycemic control and glycemias
> 150mg/d) x 100.
Results: the mean age of subjects was 64 years, with 73% male and 27% women. A 41% of the sample suffered Type 2 diabetes, 1% suffered Type I diabetes, and 58% had no diabetes. A range of glycemias between 151 mg/dl and 323 mg/dl was obtained. The minimum level of the indicator required by the SEMICYUC (80%) was not reached in any of the three months measured, thus being in a sub-standard situation.
Conclusions: there is no adequate maintenance of the glycemic levels in patients managed in our unit; therefore, a review of the current protocol for insulin therapy could improve the quality and safety in this aspect of care.

Keywords:

Glycemia; quality indicator; critical patient; intensive care; insulin therapy

Versión en Español

Título:

Mantenimiento de niveles apropiados de glucemia en el paciente crítico. Cumplimiento del indicador de calidad