SATS 2009 Final Program - Scandinavian Association for Thoracic ...

S03:5
NURSEMANAGED INSULIN PROTOCOL IMPROVES TREATMENT OF HYPERGLYCAEMIA IN PATIENTS
WITH DIABETES UNDERGOING OPEN HEART SURGERY
Lange Aase 1
1) Aarhus University Hospital Skejby, Denmark
Background
Strict glycemic control in critically ill patients is challeging for both nurses and physicians. Studies Have shown
that aggressive glycemic control by a nursemanaged subcutaneous insulin protocol outside ICU improves mortality
and morbidity as well as efficiency and safety. An audit made in 2006 at the Department of Cardiothoratic
Surgery at Aarhus University Hospital Skejby, Denmark showed that only 62 % of patients with hyperglycemia
were treated according to recommendations. The low compliance was presumably due to fear of hypoglycaemia
and lack of knowledge.
Objectives
To determine the effect of focused education of nurses followed by implementation of a nursemanaged insulin protocol.
Methods
Intensive education of nurses followed by development and implementation of a nursemanaged insulin protocol. Two
audits to determine if hyperglycaemia was treated according to the implemented insulin protocol. Blood glucose
levels and insulin doses per day were documented in 15 patients before and in 15 patients after implementation of
the protocol.
Results
Audit in 2006: number of measured hyperglycaemia values in 15 patients was 105 and 62 % were treated according
to reccommendations. Audit in 2009: number of measured hyperglycaemia values in 15 patients after implementation
of insulin protocol was 263 and 90,5 % were treated according to the nursemanaged insulin protocol.
Conclusions
Intensive education followed by development and implementation of a nursemanaged insulin protocol has increadsed
compliance and led to a considerable improvement in the treatment of hyperglycaemia. Potentially this could lead to
improved mortality and morbidity for this patientgroup.
S03:6
PREVALANCE OF POSTOPERATIVE PROBLEMS AMONG DANISH HEART-OPERATED PATIENTS
14 DAYS AFTER DISCHARGE FROM HOSPITAL
Ibsen Dorthe 1 , Greve Helle 1
1) Rigshospitalet, Denmark
Background
Several patients call the heart-surgery ward because they don’t know where to address problems related to dyspnoea,
medication, and infections. International research documents that many heart-operated patients experience
emotional and physiological problems one year after their operation. The aim of this study is to gain knowledge
about Danish heart-operated patients´ experience of these problems during the first 14 days after discharge from
hospital, to uncover if the constructed questionnaire is useful to gain information about this, and as background for
a clarifying telephone interview.
Method
Data was acquired by use of a semistructured questionnaire, followed up by telephone-interviews. 9 patients were
asked to complete the questionnaire, and to participate in the interview 14 days after discharge. The results are
preliminary as the study is not yet completed. 8 patients participated in the study, 6 males and 2 females, age
between 50-72 years. 6/8 experienced depression in the first 7-14 days, 7/8 pain, 6/8 sleeping problems, 6/8 lack
of energy.
Conclusions
Danish heart surgery patients seem to have the same emotional and physiological problems during the first 14 days
after discharge, as shown in international research. The semistructured questionnaire and telephone interviews
formed a basis for gaining knowledge of patients’ problems during the first 14 days at home. According to the
preliminary results it seems important that nurses call their patients after discharge, and individualize the discharge
dialogue to make sure that patients are more capable to act adequate upon the challenges, experienced after their
discharge from hospital.
STOCKHOLM, SWEDEN 43