NURSING PROTOCOL FOR GLYCEMIC MONITORING IN HOSPITALIZED INDIVIDUALS WITH TYPE 2 DIABETES MELLITUS<sup/>

Frota, Gesiane Araújo; Silva, Denise Maria Guerreiro Vieira da; Ferreira, Darlisom Sousa; Arruda, Cecília; Ribeiro, Maria de Nazaré de Souza; Boell, Julia Estela Willrich; Ramos, Flávia Regina Souza

doi:10.1590/ce.v29i0.94177

Acessibilidade / Reportar erro

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

ORIGINAL ARTICLE • Cogitare Enferm. 29 • 2024 • https://doi.org/10.1590/ce.v29i0.94177 copy

NURSING PROTOCOL FOR GLYCEMIC MONITORING IN HOSPITALIZED INDIVIDUALS WITH TYPE 2 DIABETES MELLITUS^* * Artigo extraído da dissertação do mestrado “Protocolo de cuidados de enfermagem para monitorização glicêmica de pessoas com diabetes mellitus hospitalizadas”, Universidade do Estado do Amazonas, Manaus, AM, Brasil, 2022.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

Developing a nursing care protocol for glycemic monitoring of hospitalized individuals with Type 2 Diabetes Mellitus.

Method:

Methodological research conducted in 2021 and 2022 in Manaus, state of Amazonas, Brazil, in three phases: 1) Theoretical phase: literature review, consensus search, development of analytical frameworks, content selection. 2) Protocol development phase. 3) Protocol evaluation phase conducted by nurses regarding clarity, relevance, and applicability.

Results:

The literature review yielded 15 articles and five consensus statements from scientific societies. The protocol consists of 11 items, with an emphasis on the identification of risk factors, manifestations of hyperglycemia and hypoglycemia, nursing care, the nursing process, and a flowchart. The nurses’ evaluation was favorable, achieving an CVI of 1.0 regarding clarity and relevance, and it was considered applicable.

Conclusion:

The protocol will support nursing care in glycemic monitoring, enabling better glycemic control for hospitalized individuals with diabetes.

DESCRIPTORS:
Nursing; Nursing Care; Methodological Research in Nursing; Diabetes Mellitus; Glycemic Control.

HIGHLIGHTS

1. Nursing care protocol for glycemic monitoring.

2. Role of the nursing team in glycemic monitoring.

3. Tool for nursing care practice.

Protocol Items	Description
1. Introduction	Presents the theme and the protocol, emphasizing the crucial role that nursing plays in this monitoring and the implications of glycemic changes on the health of hospitalized individuals with T2DM
2. Objective	The following was stablished: Supporting the nursing team in glycemic monitoring of individuals with T2DM admitted to the study hospital.
3. Risk factors	Twelve risk factors for glycemic alterations are highlighted, upon which nursing can intervene to modify them, and special attention should be given to their early detection.
4. Glycemic goals	It aims to guide nursing on acceptable blood glucose ranges, as well as levels of hypoglycemia and values considered as hyperglycemia.
5. Signs and symptoms of hyperglycemia and hypoglycemia	The main manifestations indicative of hypoglycemia are listed, organized into two subsections: Signs and symptoms of adrenaline activation (neurogenic or autonomic) and signs and symptoms of neuroglycopenia. For hyperglycemia, signs and symptoms of hyperglycemia and hyperosmolar hyperglycemic state are indicated.
6. Technical procedures for blood glucose measurement	It presents the main points for capillary blood glucose practice and other measurement methods. A Standard Operating Procedure (SOP) has been developed, accompanying the protocol (appendix) on the Capillary Blood Glucose Measurement Technique.
7. Nursing interventions based on blood glucose results	These are related to nursing interventions for each case, separately presenting the measures for hypoglycemia and hyperglycemia, including a table with three columns: care to be performed, considerations about these care measures, and the nursing professional responsible for their execution.
8. General nursing care for glycemic monitoring	The care measures have been organized into a table with four subsections: 1. Actions to prevent glycemic alterations; 2. 3. Blood glucose assessment actions; 4. 4. Blood glucose control actions; 4. Educational actions. Each subsection consists of care measures to be performed, considerations about these care measures, and the nursing professional responsible for their execution.
9. Nursing process related to glycemic monitoring	A care systematization proposal was presented, organized as proposed by Cofen (2009): Nursing History, Nursing Diagnosis, Nursing Planning, Nursing Implementation, and Nursing Evaluation. Relevant aspects for glycemic monitoring were highlighted in each stage of the process.
10. New technologies for glycemic monitoring	Two new technologies, already available in the Brazilian market, have been included: Continuous real-time glucose monitoring, Flash Glucose Monitoring System, with the intention of promoting the recognition of these technologies, in the hope that they will be incorporated into the routine of the study hospital.
11. Flowchart	It provides an overview of the activities to be carried out for glycemic monitoring, indicating the decision points for the nurse in glycemic monitoring.

Evaluation items and subitems	CVI^* * CVI: Content Validity Index. Clarity	CVI^* * CVI: Content Validity Index. Relevance
1. Introduction	1.0	1.0
2. Objectives	1.0	1.0
3. Risk Factors for Glycemic Alterations	1.0	1.0
4. Glycemic goals	1.0	1.0
5. Signs and symptoms of hyperglycemia and hypoglycemia	1.0	1.0
6. Technical procedures for blood glucose measurement	1.0	1.0
7. Nursing interventions based on blood glucose results	1.0	1.0
8. General nursing care for glycemic monitoring	1.0	1.0
9. Nursing process related to glycemic monitoring	1.0	1.0
10. New technologies for glycemic monitoring	1.0	1.0
11. Flowchart	1.0	1.0

Universidade Federal do Paraná Av. Prefeito Lothário Meissner, 632, Cep: 80210-170, Brasil - Paraná / Curitiba, Tel: +55 (41) 3361-3755 - Curitiba - PR - Brazil
E-mail: cogitare@ufpr.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Corresponding author: Gesiane Araújo Frota, Hospital Universitário Getúlio Vargas, Rua Tomas de Vila Nova, 300 - Centro, Manaus - AM, CEP: 69020-170, E-mail: gesiane.frota@ebserh.gov.br