Insulin drip/hourly BG checks

Back when everyone was on "tight control" (80-110), those patients were only in ICU. Now that best practice is to let them get up to 150 or even 180, we do insulin drips with a ratio as high as 5:1 on nights, 4:1 on days.

In my hospital anyone on an insulin drip has to either be on a monitored unit (cause their ratios are lower) or in the ED cause, you know, we have nothing but free time.

Pts on insulin drip are only admitted to the CCU at the facility I work at. Pts can not transfer until the drip has be D/C.

If a pt needs an insulin drip they are sent to the ICU. We don't have the ratios to accommodate hourly BG checks.

We take insulin gtts on our medsurg unit. We have a GI/Organ Transplant focus with a few tele beds. I've had pts on insulin gtts with 3 other patients (usually we have 4-5 pts between 0700-2300 and up to 6 2300-0700).

Insulin gtts are primarily in ICU and the cardiovascular surgical unit where I work given the patient population of post CABG patients. The ratio remains the same, 3 pts on days, 4 on eves and 5-6 on nights. Medsurg units are able to have insulin gtts if needed, but not sure of the ratio for patients there.

I work on a medsurg floor where it's a 5:1 ratio and we get insulin drips. They usually try to give a nurse only one, but your four other patients could have heparin drips etc and you still have your hands full.

I've had an insulin gtt with 6 telemetry patients (meaning 6 pt's total). At my hospital money is far more important than anything else. If you're lucky a co-worker would offer to do a check for you when you're too busy to go in right on the hour.

We recently had a policy change that all insulin gtts have to be done on a monitored unit, usually pcu or Ccu. Saves us med surg nurses a lot of running and worrying! I'm very happy they implemented this new change.