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RES209
A Qualitative Study to Determine Nurses’ Perceptions of Glycemic Control in the Cardiac Surgery Patient
By: Linda Henry, Linda Halpin, Elizabeth Dunning, Janice White, Debra Stanger, & Lisa Martin; Inova Heart and Vascular Institute, Falls Church, VA
For further information, please contact: lhenry6@cox.net
Purpose: Building upon our previous work which discerned the nurse’s perceptions of their workload, this study’s purpose was to further explore the nurses’ thoughts on the glycemic control protocol.
Background/Significance: Previous work investigating the effects of glycemic control in cardiac surgery patients has demonstrated obtaining/maintaining blood glucose values between 80 and 120 is imperative in achieving excellent clinical outcomes in the cardiac surgical patient. However, the caregiver’s workload associated with meeting this goal is only now beginning to be understood.
Methods: This qualitative study used focus groups held on 3 consecutive days to interview nurses in the CVICU and CVSD units about their thoughts on glycemic control. 3 research questions developed from our previous work were used to help guide the discussion: a. If this was a perfect world (utopia), what would you want to have in your work place that would allow you to achieve tight glucose control with your patients? b. What patient outcomes would be important for you to see in order to know that achieving tight glycemic control is worth all the work involved? c. What thoughts or decisions go into making glycemic control important to you?
Results: 10 nurses (3 from CVICU and 7 from CVSD) participated in the focus groups; however, saturation was accomplished. The essence of the nurses’ message was that they recognize glycemic control as a very important part of their patient care. However, in order to be able to perform this intervention they will need: available equipment; a designated person to obtain all blood glucose values; periodic updates on patient outcomes related to glycemic control and a way not to have to be as intrusive with the patient in order to draw the blood. Conclusions: The ability of the nurses to obtain glycemic control is hindered by: the lack of time; lack of necessary resources equipment; lack of knowledge about the long term outcomes as a result of glycemic control and the discomfort to patients caused by the required frequent blood draws.
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