Continuous Insulin drip

[jocolorado]

Hi- I am looking for some information regarding caring for patients with continuous insulin drips on the floor. My hospital has recently instituted an "APCIIOS" insulin drip protocol which is based on the Portland Protocol. My problem is the research I am able to find on the continuous infusion, no matter who's protocol the patients are either in ICU or a step down unit. My managers have agreed to meet with a few of us staff nurses to listen to our concerns regarding patient safety. Currently we are receiving these patients from ICU and having to do fingersticks every half hour to hourly and have four or five other patients. As you can imagine it is overwhelming and dangerous for everyone involved. I would like to have some actual statistics to bring to the meeting other than our hysteria!

Thank you

[Geeg]

Insulin drips are not appropriate on the floor. Check with other hosp in your town to see what the standard of care is.

[VivaLasViejas, ASN, RN]

Where I worked before, we got insulin drips on Med/Surg after both the MDs and the ICU nurses pleaded with the powers that be to 'let' us do them. Well and good (I'd done them many times in critical care and had no problem with them, but that was when I had only one or two patients!), TPTB said Fine, any nurse who has a patient on an insulin drip only has to take 2-3 patients. Of course, that didn't last long.........next they said "well, we'll count the insulin drip pt. as TWO pts." which meant we could still have 5 pts. WITH the insulin drip.:stone And of course, since they didn't take pt. acuity into consideration, we could conceivably have 4 heavy care patients, the insulin drip, AND get an admission or a post-op after 3 PM.

Just another really good reason why I don't work in acute care anymore.:stone

[ZASHAGALKA, RN]

bad idea to have ANY gtt that can kill somebody running and attended by a nurse that has 5 other pts.

Not only does the gtt and the accucheck have to be monitored, so does the EFFECTS on the pt. And THAT takes more than running in and changing a number on a pump every hour or so.

I'm sure I'm preaching to the acute care choir, but that's just dangerous.

~faith,

Timothy.

[bonesrn]

Our LTAC...staffed by more LPN's than RN's is getting ready to start accepting patients on Cardizem, Dopamine/Dobutamine and Amiodarone drips...they say they will take only 2 patients at a time with these drips but I am skeptical...it all comes down to money and we are losing patients to other "specialty" units that are housed within the hospitals..I see big problems in our future!.. Good Luck with the insulin drips..keep advocating for your patients safety and the safety of your license..I know I will!