{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T07:26:42Z","timestamp":1743751602499},"reference-count":25,"publisher":"Wiley","issue":"19-20","license":[{"start":{"date-parts":[[2016,4,27]],"date-time":"2016-04-27T00:00:00Z","timestamp":1461715200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Clinical Nursing"],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:sec><jats:title>Aims and Objectives<\/jats:title><jats:p>To determine whether a low\u2010dose intravenous insulin regimen reduces blood glucose levels at a timely rate and associated side effects among patients with Acute Coronary Syndrome and Left Ventricular Failure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Induced hypoglycaemia and the associated risks have questioned the benefits of intensive insulin therapy in patients presenting with raised blood glucose levels and Acute Coronary Syndromes. Local audit data identified that patients with Acute Coronary Syndrome and Left Ventricular Failure experienced more hypoglycaemic episodes than those with Acute Coronary Syndrome alone. Consequently, a new regimen of low\u2010dose insulin for this group was implemented and audited over 12\u00a0months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Audit.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thirty\u2010six consecutive patient notes with a diagnosis of Acute Coronary Syndrome and blood glucose of \u226510\u00a0mmol\/l treated with a new insulin therapy regimen were analysed. Data were extracted using a standardised form and entered into an Excel spreadsheet for analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean age of the sample was 70\u00a0years with 66% of subjects being men and 50% presenting with Acute Coronary Syndrome and Left Ventricular Failure. The low\u2010dose regimen was effective in achieving normoglycaemia, (range 4\u20138\u00a0mmol\/l) for a consecutive six\u2010hour period. This was achieved in 72% of patients and within a median time of 13\u00a0hours.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The audit suggests that a low\u2010dose insulin regimen can effectively stabilise blood glucose in patients presenting with both Acute Coronary Syndrome and Left Ventricular Failure. The importance of regularly monitoring blood sugar levels is vital and highlights the role of nurses in minimising patient risk and promoting safety.<\/jats:p><\/jats:sec><jats:sec><jats:title>Relevance to practice<\/jats:title><jats:p>Nurses are instrumental in the safe implementation of intensive insulin guidelines. Close monitoring of patients is essential, enabling timely adjustments to treatments and ensuring patient safety. Regular audits allow nurses to evaluate care provision and continue to drive practice forward.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocn.13257","type":"journal-article","created":{"date-parts":[[2016,4,27]],"date-time":"2016-04-27T14:41:34Z","timestamp":1461768094000},"page":"3001-3009","source":"Crossref","is-referenced-by-count":3,"title":["Low\u2010dose intensive insulin therapy in patients with Acute Coronary Syndrome accompanied by Left Ventricular Failure: audit of two <scp>UK<\/scp> hospitals"],"prefix":"10.1111","volume":"25","author":[{"given":"Nicola","family":"Manning","sequence":"first","affiliation":[{"name":"Cardiac Rehabilitation Department North Bristol NHS Trust Southmead Hospital Bristol UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John W","family":"Albarran","sequence":"additional","affiliation":[{"name":"Centre for Clinical and Health Science Research Faculty of Health &amp; Social Care University of the West of England Bristol UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,4,27]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/aft201"},{"key":"e_1_2_13_3_1","doi-asserted-by":"crossref","first-page":"370","DOI":"10.4037\/ajcc2006.15.4.370","article-title":"Evaluation of nursing work effort and perceptions about blood glucose testing in tight glycemic control","volume":"15","author":"Aragon D","year":"2006","journal-title":"American Journal of Critical Care"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcnurse.2008.12.001"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.29.04.06.dc05-1894"},{"key":"e_1_2_13_6_1","first-page":"8","article-title":"Sliding\u2010scale insulin: an ineffective practice","volume":"5","author":"Coggins M","year":"2012","journal-title":"Aging Well"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.27.2.461"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2702.2010.03590.x"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2702.2011.03956.x"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/qhc.9.1.23"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.12448"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.496"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2008.593"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(95)00126-K"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehi199"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2008.152835"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.12002"},{"key":"e_1_2_13_18_1","first-page":"49","article-title":"Optimization of blood glucose control in mi patients: state of the art and a proposed protocol for intensive insulin therapy","volume":"28","author":"Monteiro S","year":"2009","journal-title":"Revista Portuguesa de Cardiologia"},{"key":"e_1_2_13_19_1","volume-title":"Management of acute coronary syndrome & hyperglycaemia collaborative project minap, abcd and nhs diabetes. 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