Congress Abstracts 2006

111

MAINTAINING TIGHT GLUCOSE CONTROL OF THE HEMATOLOGIC ONCOLOGY PATIENT. Lisa Privitere, RN, OCN^®, Roswell Park Cancer Institute, Buffalo, NY.

Current research has demonstrated that tight glucose control has positive outcomes in surgical patients. The evidence demonstrates that a blood glucose level maintained between 80 and 150mg/dc, showed a decrease in the mortality rate.

Literature does not specifically address the needs of hematology oncology patients. Maintaining tighter control of blood glucose levels in this specific population may be of great significance due to their disease state and treatments. Steroids are frequently prescribed, thus potentially causing hyperglycemia. An insulin protocol was developed and initiated when a medical oncology patient, had three consecutive blood glucose levels of 150mg/dc or greater.

The purpose of maintaining tight blood glucose levels is directly related to the significant reduction in hospital mortality, acute renal failure, bacteremia, red cell transfusions and critical care management, thus improving outcomes while reducing cost.

The treatment plan for the hematologic oncology patient may require the nurse to administer steroids and dextrose containing intravenous fluids. These treatments routinely cause an increase in the blood glucose levels to above normal, creating risk.

A six month evaluation of the hematology oncology patients prior to and past the initiation of the protocol, was completed and clinical outcomes measured

Maintaining tight glucose control in hematology oncology patients proves to be beneficial. The insulin protocol is a nurse-directed protocol that is a proactive means of therapy. Treatment and duration of such medications that induce high glucose levels is a practice to be evaluated for broad application to this high-risk oncology patient population.