Management of intravenous insulin infusion in critically ill patients in the intensive care unit: a best practice implementation project

ABSTRACT Introduction: Intravenous insulin infusion is essential for managing hyperglycemia in patients in the intensive care unit (ICU). Inadequate management can result in serious complications, including hypoglycemia, which, if untreated, can lead to irreversible nerve damage or death. Objective: This project aimed to implement evidence-based practices for managing intravenous insulin infusion among critically ill ICU patients at a public tertiary hospital in China. Methods: This quality improvement project employed a pre-post audit design guided by the JBI Implementation Framework and the JBI Model of Evidence-Based Health care. The project followed a seven-phase approach incorporating evidence-based auditing and feedback mechanisms. JBI's Practical Application of Clinical Evidence System (PACES), Getting Research into Practice (GRiP) tool, and the CFIR-ERIC Implementation Strategy Matching Tool supported data collection, analysis, and implementation planning. Results: Significant improvements in compliance with the best practices were observed. Timely initiation of insulin infusion increased from 45% to 86.67%, while maintaining glucose within the target range increased from 0% to 70%. The use of validated insulin infusion protocols increased from 0% to 78.3%, blood glucose monitoring frequency from 80% to 95%, and arterial sampling for blood glucose monitoring from 1.4% to 68.8%. Conclusions: The project greatly improved adherence to evidence-based practices in insulin infusion management and improved overall patient care in ICUs. Spanish abstract: http://links.lww.com/IJEBH/A538