• Journal of Korean Clinical Nursing Research
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• v.15 no.3
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• pp.27-38
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• 2009

Purpose: The purpose of this study was to develop a blood glucose control protocol for medical intensive care unit (ICU) patients. Methods: The blood glucose control protocol was developed through the following process: selection of preliminary protocols, clinical application, and evaluation. The clinical validity of the protocol was measured by application, along with examination of the effects of the Yale and the Mayo blood glucose protocols. Seventeen medical ICU adults patients whose blood glucose levels exceeded 200 mg/dL consecutively participated in the study. The development protocol was evaluated by an expert group. Results: Incidence of normal blood glucose levels (p=.041) increased significantly in the Yale protocol application group. Also, incidence of severe hyperglycemia (p=.029) decreased significantly and time to target range of glucose (p=.023) decreased significantly after application of the Yale protocol. However, there was no significant difference in incidence of hypoglycemia (p=.666) between three groups. Conclusion: Using the developed protocol as a basis for the modified Yale protocol was found to be effective in improving the state of blood glucose control for medical ICU patients and is expected to be used for nursing intervention in critical care.

• Journal of Korean Critical Care Nursing
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• v.8 no.2
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• pp.1-12
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• 2015

Purpose: The study sought to determine the state of blood glucose control, and the consequent clinical effects and variation in blood glucose level, of adult patients admitted to intensive care units following cardiothoracic surgery by comparing the blood glucose levels before and after the application of a blood glucose control protocol. Methods: The protocol was developed by modifying and supplementing the Yale protocol, and was first used in 2012. The resulting blood glucose data of an experimental group (n = 314), to which the blood glucose control protocol had been applied, and a control group (n = 347), whose blood glucose levels had been controlled according to physicians'prescriptions without the protocol, were collected through the medical records. Results: The target blood glucose ratio increased significantly in the experimental group, and the low blood glucose ratio decreased significantly in the experimental group. The two groups exhibited a significant difference (p < .001) in the degree of variation in the blood glucose levels. The duration of the use of a ventilator was significantly reduced in the experimental group (p < .001). Conclusion: It is expected that the protocol can be used for the safe and effective control of critically ill cardiothoracic surgery patients' blood glucose levels.

• Journal of Korean Critical Care Nursing
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• v.7 no.2
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• pp.45-57
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• 2014

Purpose: The purpose of this study was to examine the effect of a blood glucose control protocol for medical intensive care unit (ICU) patients. Methods: The subjects were recruited from medical ICU adult patients whose blood glucose levels exceeded 200 mg/dL in two consecutive tests. The experimental group (n=62) received the modified Yale (MY) insulin protocol, whereas the control group (n=64) was treated with the conventional insulin therapy methods. Results: In the experimental group, the mean blood glucose levels (p<.001) and the time to reach the target range of glucose (p<.001) decreased significantly while the incidence rates of a target range of glucose of 100-140 mg/dL (p<.001) increased significantly as compared to the control group. However, no statistically significant differences were found in the incidence of hypoglycemia(p=.644), or the number of glucose tests (p=.236) between the groups. The length of stays in the ICU (p=.001), ventilator care days (p=.038), and the Sequential Organ Failure Assessment (SOFA) score (p=.029) in the experimental group were significantly lower than those of the control group. Conclusion: Application of the protocol was effective in improving the state of blood glucose control in medical ICU patients. Therefore, this protocol is expected to be used as a part of nursing intervention in critical care nursing.

• Journal of health informatics and statistics
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• v.43 no.4
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• pp.307-317
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• 2018

Objectives: This study aimed to verify the effectiveness of Internet-based intervention programs for adults with diabetes by conducting a meta-analysis of studies conducted since 2000. Methods: We conducted a systematic review of research papers published in domestic and overseas journals from January 2000 to December 2015, and selected 9 papers that met the analysis criteria. Data analysis was performed using the open source statistical software R 3.5.0, to analyze the effectiveness of Internet-based interventions on experimental and control groups. Results: The analysis showed that intervention programs for controlling HbA1c levels in adult patients with diabetes most commonly comprised 7 sessions on Internet-based management (77.8%), and the most common frequency of application of intervention programs was 4 session in 6 months (33.4%). The present meta-analysis revealed statistically significant effects of Internet-based intervention activities (SMD = 0.92, 95% CI 0.45-1.40). The analysis of the effect size according to the intervention period showed that the 3-month, 6-month, and 12-month interventions reported in eight studies (89%) had a high effect on the Internet-based intervention group. Conclusions: The results of this study confirm the effectiveness of Internet-based intervention programs for adult patients with diabetes. The need for research on the utilization of Internet-based intervention programs for the steady management of diabetes, a chronic disease; for the development of specific guidelines for intervention activities; and for establishing appropriate protocols are acknowledged.