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Discussion

Insulin Gtt

Within the last month we began using insulin gtts pre and post op on our surgery patients. When we were inserviced on this gtt we were informed our pt ratio would be 3:1 and the floor would only have one gtt at a time. Well we are only taking one pt on insulin gtt which is most often the post of patient because we only take post open hearts. The issue at hand is the ratio 3:1 is not being used. I had a pt last night with an insulin gtt and started out with 3 pt's. I still managed to get behind because I was constantly having to go back to my gtt since my pt was still being monitored anywhere from q30 min to q1hr. At 2300 I then picked up my fourth pt. I was then informed that if our beds were full I could take up to five pts including a gtt. I'm interested in hearing anyone elses ratios or if you have any research that your aware of on these gtts.

Thanks for your help

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We use insulin gtts often and don't have any specific protocol on ratios related to them. I've had 3 pts with 2 on insulin gtts. It's a pain, but do-able. Especially since we just changed our calculation protocols, and now they require some kind of adjustment every hour.

I would definitely ask whoever told you that you would not have more than 3 pts with an insulin gtt why this is not being followed. Is the ratio actually written into the protocol?

My suggestion is to try and advocate to the docs to get rid of the drips quicker. If you're patient is taking PO, there's no reason they should be on an insulin drip, even if they were poorly controlled pre-op, which is often the case. If a patient is still lined, vented, and all, then it might be appropriate, but even then I try to get the doc to at least let nursing check glucoses every 2 hours instead of the typical every hour.

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