Intensive Care Unit, Military Hospital, Khartoum, Sudan.
University of Medical Sciences and Technology UMST, High Diploma in Research Methodology and Biostatistics, Khartoum, Sudan, Khartoum, Sudan.
PLoS One. 2022 May 24;17(5):e0267655. doi: 10.1371/journal.pone.0267655. eCollection 2022.
Hyperglycaemia is a major risk factor in critically ill patients leading to adverse outcomes and mortality in diabetic and non-diabetic patients. The target blood glucose remained controversial; this study aimed to contribute in assessing the practice of hyperglycaemia control in intensive care units of the Military Hospital. Furthermore, the study proposed a protocol for hyperglycaemia control based on findings. A hospital-based cross-sectional study assessed the awareness and practice towards hyperglycaemia management in a sample 83 healthcare staff selected through stratified random sampling technique. In addition, 55 patients were enrolled, through quota sampling, after excluding those with diabetic ketoacidosis, hyperosmolar-hyperglycaemic state and patients < 18 years. A self-administrated questionnaire enabled to collect data from health staff and patient data were extracted from the medical records. SPSS-23 was used to analyze the collected data. Chi-square and ANOVA tests assessed the association among variables, these tests were considered statistically significant when p ≤ 0.05. The training on hyperglycaemia control differed (p = 0.017) between doctors and nurses. The target glycaemic level (140-180 mg/dl) was known by 11.1% of the study participants. Neither the knowledge nor the practice of hyperglycaemia control methods differed among staff (p> 0.05). The use of sliding scale was prevalent (79.3%) across the ICUs (p = 0.002). 31.5% of the patients had received different glycaemic control methods, 11.8% were in the targeted blood glucose level. Sliding scale was the method used by doctors and nurses (71.4% and 81.6% respectively). Lack of awareness about hyperglycaemia management methods was prevalent among ICU healthcare staff. Use of obsolete methods was the common practice in the ICUS of the Military Hospital. Target blood glucose for patients were unmet. Development of a local protocol for glycaemic control in all ICUs is needed along with sustained training programs on hyperglycaemia control for ICU healthcare staff.
高血糖是危重症患者的主要危险因素，可导致糖尿病和非糖尿病患者的不良结局和死亡。目标血糖值仍然存在争议；本研究旨在评估军事医院重症监护病房高血糖控制的实践情况。此外，根据研究结果提出了高血糖控制方案。一项基于医院的横断面研究评估了通过分层随机抽样技术选择的 83 名医护人员对高血糖管理的认识和实践。此外，通过配额抽样，排除糖尿病酮症酸中毒、高渗性高血糖状态和 < 18 岁的患者后，共纳入 55 名患者。通过自填式问卷收集医护人员数据，并从病历中提取患者数据。使用 SPSS-23 分析收集的数据。卡方检验和方差分析评估变量之间的关系，当 p ≤ 0.05 时，这些检验被认为具有统计学意义。医生和护士之间的高血糖控制培训存在差异（p = 0.017）。研究参与者中只有 11.1%知道目标血糖水平（140-180mg/dl）。医护人员的高血糖控制方法的知识和实践都没有差异（p>0.05）。在各重症监护病房（p = 0.002）中，滑动比例法（79.3%）最为常用。31.5%的患者接受了不同的血糖控制方法，11.8%的患者血糖水平达标。滑动比例法是医生和护士使用的方法（分别为 71.4%和 81.6%）。重症监护病房医护人员普遍缺乏高血糖管理方法的认识。过时的方法在军事医院重症监护病房中普遍使用。需要在所有重症监护病房制定当地血糖控制方案，并为重症监护病房医护人员提供持续的高血糖控制培训计划。
