AORN Journal
Volume 90, Issue 5 , Pages 714-730, November 2009

Glycemic Control: A Literature Review with Implications for Perioperative Nursing Practice

  • Kristina A. Kittelson, BSN, RN

      Affiliations

    • Kristina A. Kittelson, BSN, RN, is an OR staff nurse at St Mary's Hospital, Grand Junction, CO. Ms Kittelson has no declared affiliation that could be perceived as a potential conflict of interest in publishing this article.

ABSTRACT 

Surgical patients have an increased risk for hyperglycemia and its subsequent complications, such as increased risk of infection, morbidity and mortality, and length of stay.

Interventional studies indicate that tight glycemic control with intensive insulin therapy improves outcomes. More recent randomized controlled trials, however, provide conflicting results, indicating that hypoglycemia and death may result from tight glycemic control. This calls into question the safety and efficacy of tight glycemic control.

Perioperative nurses must be prepared to implement measures to control hyperglycemia for patients with and without diabetes throughout the perioperative process. Perioperative nurses should participate in multidisciplinary efforts to develop evidenced-based glycemic control protocols. AORN J 90 (November 2009) 714–726. © AORN, Inc, 2009.

Key words:  perioperative hyperglycemia , glycemic control , intensive insulin therapy , continuous insulin infusion

 

 Complete this CE activity online at aorn.org/CE indicates that continuing education contact hours are available for this activity. Earn the contact hours by reading this article and taking the examination on pages 727–728 and then completing the answer sheet and learner evaluation on pages 729–730. The contact hours for this article expire November 30, 2012.The latest version of the Portland Protocol for continuous insulin infusion is available for download at http://www.portlandprotocol.org.The behavioral objectives and examination for this program were prepared by Rebecca Holm, RN, MSN, CNOR, clinical editor, with consultation from Susan Bakewell, RN, MS, BC, director, Center for Perioperative Education. Ms Holm and Ms Bakewell have no declared affiliations that could be perceived as potential conflicts of interest in publishing this article.This program meets criteria for CNOR and CRNFA recertification, as well as other continuing education requirements.AORN is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.AORN recognizes these activities as continuing education for registered nurses. This recognition does not imply that AORN or the American Nurses Credentialing Center approves or endorses products mentioned in the activity.AORN is provider-approved by the California Board of Registered Nursing, Provider Number CEP 13019. Check with your state board of nursing for acceptance of this activity for relicensure.

PII: S0001-2092(09)00539-0

doi:10.1016/j.aorn.2009.07.026

AORN Journal
Volume 90, Issue 5 , Pages 714-730, November 2009

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