Trial Information

Clinical Process Improvement With A Bedside Computerized Insulin Therapy Protocol For Blood Glucose Control (eProtocol-Insulin) in Adult And Pediatric Intensive Care Unit Patients-Second Phase (Phase-2): Distribution and Implementation of Validated eProtocol-Insulin in Naïve ICUs

In the current second phase of this project (Phase-2), we will introduce the refined,
validated, and safe eProtocol-insulin into a second group of naïve ICUs, none of which
participated in eProtocol-insulin development, refinement or validation. Our primary goal
in this second phase is to determine the feasibility of exporting this tool to naïve ICU
environments. In this second phase we will also compare the effects of the eProtocol-insulin
and ordinary care approaches to glucose control on the bedside nurse's experience.

This second phase will be a prospective cohort study. We will determine the feasibility of
distributing eProtocol-insulin and will further validate eProtocol-insulin in >4 adult and
>4 pediatric ICUs. If necessary we will modify eProtocol-insulin with an iterative
refinement process, with Institutional Review Board (IRB) and independent Data and Safety
Monitoring Board (DSMB) oversight. eProtocol-insulin will be considered refined if >90% of
the instructions are accepted and if the percent of glucose values between 70 and 110 mg/dl
(3.9-6.1 mMol/L) are equivalent to our Phase-1 refinement and validation experience of 46%%,
and if the rate of glucose values < 40 mg/dl (2.2 mMol/l) is less than 0.5% of glucose
measurements.