Virtual trial protocol analysis of nursing workload intensity within ICU

Normy Norfiza Abdul Razak, A. A. Razak, C. G. Pretty, N. H. Ahamad, F. M. Suhaimi, U. Jamaluddin

Research output: Chapter in Book/Report/Conference proceedingConference contribution

1 Citation (Scopus)

Abstract

Currently, effective glycaemic control protocols consume significant nursing time, which may be unsustainable as the number of patients requiring control increases with increasing rates of diabetes. This paper investigates the safety and efficacy of basal insulin therapy as a means to reduce nurse workload associated with glycaemic control in intensive care patients with stress hyperglycaemia. Validated virtual trial simulations (N = 40 patients) of a successful glycaemic control protocol (SPRINT) using 1-2 hourly interventions and a modified version using 4 hour interventions augmented with basal insulin therapy using Glargine. An additional model was used to capture the kinetics of Glargine. Workload was assessed by counting the total number of interventions (BG measurements, changes to insulin and nutrition rates) per day. Glycaemic performance was assessed by time in the target band (4.4-7.0 mmol/L) and number of severe hypoglycaemic episodes (BG<2.2 mmol/L). Workload reduction is around 30% (p<0.001) due to basal insulin therapy. Glycaemic control performance was slightly reduced from 86% to 80% (p=0.006) time in the target band using basal insulin therapy and 4 hourly interventions. However, safety was maintained with 0 incidence hypoglycaemia. Basal insulin therapy enables glycaemic control protocols with reduced intervention frequency while maintaining performance and safety. Reduced intervention frequency directly translates into reduced nurse workload associated with glycaemic control.

Original languageEnglish
Title of host publicationInternational Conference for Innovation in Biomedical Engineering and Life Sciences
EditorsFatimah Ibrahim, Mas Sahidayana Mohktar, Mohd Yazed Ahmad, Juliana Usman
PublisherSpringer Verlag
Pages294-297
Number of pages4
ISBN (Print)9789811002656
DOIs
Publication statusPublished - 01 Jan 2016
EventInternational Conference for Innovation in Biomedical Engineering and Life Sciences, ICIBEL 2015 - Putrajaya, Malaysia
Duration: 06 Dec 201508 Dec 2015

Publication series

NameIFMBE Proceedings
Volume56
ISSN (Print)1680-0737

Other

OtherInternational Conference for Innovation in Biomedical Engineering and Life Sciences, ICIBEL 2015
CountryMalaysia
CityPutrajaya
Period06/12/1508/12/15

Fingerprint

Intensive care units
Nursing
Insulin
Nutrition
Medical problems
Hypoglycemic Agents
Kinetics

All Science Journal Classification (ASJC) codes

  • Bioengineering
  • Biomedical Engineering

Cite this

Abdul Razak, N. N., Razak, A. A., Pretty, C. G., Ahamad, N. H., Suhaimi, F. M., & Jamaluddin, U. (2016). Virtual trial protocol analysis of nursing workload intensity within ICU. In F. Ibrahim, M. S. Mohktar, M. Y. Ahmad, & J. Usman (Eds.), International Conference for Innovation in Biomedical Engineering and Life Sciences (pp. 294-297). (IFMBE Proceedings; Vol. 56). Springer Verlag. https://doi.org/10.1007/978-981-10-0266-3_62
Abdul Razak, Normy Norfiza ; Razak, A. A. ; Pretty, C. G. ; Ahamad, N. H. ; Suhaimi, F. M. ; Jamaluddin, U. / Virtual trial protocol analysis of nursing workload intensity within ICU. International Conference for Innovation in Biomedical Engineering and Life Sciences. editor / Fatimah Ibrahim ; Mas Sahidayana Mohktar ; Mohd Yazed Ahmad ; Juliana Usman. Springer Verlag, 2016. pp. 294-297 (IFMBE Proceedings).
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abstract = "Currently, effective glycaemic control protocols consume significant nursing time, which may be unsustainable as the number of patients requiring control increases with increasing rates of diabetes. This paper investigates the safety and efficacy of basal insulin therapy as a means to reduce nurse workload associated with glycaemic control in intensive care patients with stress hyperglycaemia. Validated virtual trial simulations (N = 40 patients) of a successful glycaemic control protocol (SPRINT) using 1-2 hourly interventions and a modified version using 4 hour interventions augmented with basal insulin therapy using Glargine. An additional model was used to capture the kinetics of Glargine. Workload was assessed by counting the total number of interventions (BG measurements, changes to insulin and nutrition rates) per day. Glycaemic performance was assessed by time in the target band (4.4-7.0 mmol/L) and number of severe hypoglycaemic episodes (BG<2.2 mmol/L). Workload reduction is around 30{\%} (p<0.001) due to basal insulin therapy. Glycaemic control performance was slightly reduced from 86{\%} to 80{\%} (p=0.006) time in the target band using basal insulin therapy and 4 hourly interventions. However, safety was maintained with 0 incidence hypoglycaemia. Basal insulin therapy enables glycaemic control protocols with reduced intervention frequency while maintaining performance and safety. Reduced intervention frequency directly translates into reduced nurse workload associated with glycaemic control.",
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Abdul Razak, NN, Razak, AA, Pretty, CG, Ahamad, NH, Suhaimi, FM & Jamaluddin, U 2016, Virtual trial protocol analysis of nursing workload intensity within ICU. in F Ibrahim, MS Mohktar, MY Ahmad & J Usman (eds), International Conference for Innovation in Biomedical Engineering and Life Sciences. IFMBE Proceedings, vol. 56, Springer Verlag, pp. 294-297, International Conference for Innovation in Biomedical Engineering and Life Sciences, ICIBEL 2015, Putrajaya, Malaysia, 06/12/15. https://doi.org/10.1007/978-981-10-0266-3_62

Virtual trial protocol analysis of nursing workload intensity within ICU. / Abdul Razak, Normy Norfiza; Razak, A. A.; Pretty, C. G.; Ahamad, N. H.; Suhaimi, F. M.; Jamaluddin, U.

International Conference for Innovation in Biomedical Engineering and Life Sciences. ed. / Fatimah Ibrahim; Mas Sahidayana Mohktar; Mohd Yazed Ahmad; Juliana Usman. Springer Verlag, 2016. p. 294-297 (IFMBE Proceedings; Vol. 56).

Research output: Chapter in Book/Report/Conference proceedingConference contribution

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Abdul Razak NN, Razak AA, Pretty CG, Ahamad NH, Suhaimi FM, Jamaluddin U. Virtual trial protocol analysis of nursing workload intensity within ICU. In Ibrahim F, Mohktar MS, Ahmad MY, Usman J, editors, International Conference for Innovation in Biomedical Engineering and Life Sciences. Springer Verlag. 2016. p. 294-297. (IFMBE Proceedings). https://doi.org/10.1007/978-981-10-0266-3_62