Utilization of computerized order entry protocols in the ICU for glucose management

This paper reports the results of an evaluation of a computer-based protocol for managing patient blood glucose. The computerized protocol, having proven successful in the Surgical ICU, was implemented in the Trauma ICU. Five nurses in the Trauma ICU were interviewed and observed while using the computer-based protocol for blood glucose management. Results of the evaluation indicated that while the computerized features, such as the calculation of insulin drip rate and patient chart scanning, were helpful, nurses were spending more time and energy than before computerization to manage patient blood glucose, and that the computerized recommended treatments were often inappropriate due to the unique patient population. Suggestions for modification of the protocol to accommodate the different patient population and needs of the Trauma ICU are provided. Also, a usability test before the implementation of the new design and a follow-up assessment soon after implementation are highly recommended.