Does anyone us glucomander ?

Trauma Columnist · Jan 27, 2018

What is is?

Columnist · Jan 27, 2018

Never heard of this so I did a search on allnurses LOL

Here is a comment from an old thread: Continuous Insulin Drip.

I work in a high risk OB unit with many antepartum patients who are on an insulin drip and have fingersticks as often as 15 minutes and may stretch as far as 2 hours. Each one has a portable computer about twice as big as a checkbook on a tall stand that is called a GLUCOMMANDER!

This computer manages the pt glucose drip by a program with parameters set by the MD. Depending on the fingerstick the drip gets adjusted or turned off and fingerstick frequency is decided by the program.

Most of our nurses call it the "cricket" for the chirruping sound it makes when asking for a new blood glucose. Also most nurses do nothing but complain about it, but it makes a huge difference in fetal outcomes as far as sugars go. Neonates whose moms have had sugars well controlled by the glucommander usually have good sugars in the first day or two. I can't say how they do in the long run though.

The only other units in our hospital that uses them are the critical care units

tokmom, BSN, RN · Jan 28, 2018

it is a glucose program for anyone who is diabetic. It is supposed to be better than sliding scale. It attaches to our EPIC program. A nurse takes the accucheck the same time they deliver the meal tray. After 30 min, the carbs are counted and the patient given insulin based on what they ate. If the time is longer than an hour from accucheck to insulin, another accucheck is ordered.

I was hoping someone has used this program.

pixierose, BSN, RN · Jan 28, 2018

We have it; however, our physician's are loathe to use it. They prefer to order the sliding scales, etc.

I'm curious on its effectiveness. The training that I attended made it look quite user friendly, so I was disappointed we don't use it.

tokmom, BSN, RN · Mar 26, 2018

it isn't overly friendly. The docs still need to manage the overall dose of insulin. It has asked us to give double digit of aspart with a BG of 90

ICU-BSN · Mar 26, 2018

My workplace uses glucomander. It is all done through Epic. We don't use the carb counting feature of it though, rather we use it for continuous insulin drips. While everyone does complain about it, it is just the pain in the behind of having such frequent blood glucose checks that gets tedious, not the program itself. I find the program very easy to use.

MunoRN, RN · Mar 26, 2018

I've used it at a couple of facilities but only for insulin drips, at both places we stopped using it because of safety issues. There's not anything inherently unsafe about the program so long as it's used as intended, which is that it provides more of a suggestion than truly reliable adjustments to an insulin drip, in both places we had issues with nurses becoming too reliant on the boluses and rate changes it was suggesting, which led to adverse events and near misses.

mmc51264, BSN, MSN, RN · Mar 27, 2018

Never heard of it and I am the Diabetes champion and an EPIC super user. For out insulin drips, we just do a manual check Q1H. Other pts have mealtime plus SS or just SS if necessary. Most are T2 on out unit, although we are getting a lot more T1s and even some t2s with pumps and CGMS. Our glucometers are linked to EPIC but nothing that takes a BG value and tells you what to do.

Sounds like a waste of money. Peds have a different system, they have a dual bag system: one has insulin and the other glucose and they titrate according to an algorithm. It works really well. My son was in the PICU for severe dka (pH of 6.8) they had him normalized in about 24 hours and then he was transferred to an intermediate unit an home the next day. talk about a whirlwind! DKA can move FAST! Went from a little sick to almost dead in less than 16 hours. Out of ICU in 24 hours and home another in another 24 hours