Computerisation of a paper-based intravenous insulin protocol reduces errors in a prospective crossover simulated tight glycaemic control study

Anthony Lee, Badia Faddoul, Azizeh Sowan, Karen L. Johnson, Kristi D. Silver, Vinay Vaidya

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

Background: Paper-based continuous intravenous insulin protocols for tight glycaemic control (TGC) are typically complex, error-prone, time-consuming and burdensome. Little is known about the errors that occur as a result of misinterpretation and whether computerised protocols reduce errors. Objective: To compare the errors resulting from protocol misinterpretation, time required to manage insulin infusions and nursing satisfaction between a computerised insulin protocol and a paper-based protocol. Methods: In a crossover study, 62 ICU nurses completed 10 TGC simulated scenarios for the computerised and paper protocols. Scenarios evaluated three phases of insulin management: initiation, titration and transition. Scenarios response errors, time to completion and user satisfaction were examined. Results: A total of 620 responses were recorded using both protocols. The computerised protocols were associated with higher user satisfaction, as well as: fewer errors in the titration (13 vs. 113 errors, p= .0001) and transition phases (9 vs. 23 errors, p= .001), fewer dosing errors, although not statistically significant (p= .096), in the initiation phase, and less time to complete in the titration phase (6 vs. 9.5. min, p= .0001). Conclusions: In a simulated environment, a computerised protocol for TGC resulted in significant insulin dosing error reduction, saved time and improved nurse satisfaction.

Original languageEnglish (US)
Pages (from-to)161-168
Number of pages8
JournalIntensive and Critical Care Nursing
Volume26
Issue number3
DOIs
StatePublished - Jun 1 2010
Externally publishedYes

Keywords

  • Computerised
  • Insulin
  • Intensive care unit
  • Interpretation errors
  • Protocol
  • Tight glycaemic control

ASJC Scopus subject areas

  • Critical Care

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