Effectiveness of the computerization of a YALE insulin infusion modified protocol in reducing the nursing workload in an Internal Medicine Department

Abstract

Hyperglycemia is a negative prognostic factor in both critical and non-critical patients. Many critically ill patients admitted to internal medicine wards present hyperglycemia and may benefit from an IV insulin therapy. The Yale Insulin Infusion Protocol (YIIP) is effective and safe in achieving the desired glucose range. However, to be used properly and safely, it requires a considerable availability of nursing resources. This probably represents the main limiting factor in using these protocols outside intensive care units. This study was performed to assess the effectiveness of a computer application which reduces the nursing workload related to managing a nurse implemented modified YIIP in our internal medicine department. Our experience showed that computerizing the YIIP algorithm is safe and effective. It leads on average to a net 30-min nursing time saving per day per patient.