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Introduction Glucose meter fingerstick readings are used to determine insulin dosing requirements prior to meals on many acute care units. Unfortunately, timing varies widely, potentially resulting in inaccurate sliding scale insulin (SSI) dosing. Study Question The authors sought to determine the effect of different timing intervals on glucose values and insulin dosing. Hypothesis Pre-prandial point-of-care fingerstick glucose results obtained more than 30 minutes before the meal will demonstrate a variation in glucose values that is not consistent with insulin dosing regimens. Materials and Methods A convenience sample of 60 adult patients with diabetes on two acute care units with orders for SSI was enrolled. Patients who were disoriented or those requiring tube feedings were excluded. Informed written consent was obtained by study investigators for all participants and the study was approved by the institutional review board. Glucose values were obtained by patient care assistants (PCAs), according to the current practice before morning and noon meals. In addition, the study nurses obtained two additional glucose meter readings immediately before insulin dosing and meal time. Results and Outcomes Data represented 60 patients receiving 108 meals. Descriptive statistics, correlation statistics, and repeated measures were used to analyze the data. Blood glucose measurements were statistically significantly lower with increased time between PCA and RN measurements (a.m. p=0.002; p.m. p=0.007). This resulted in lower insulin dose requirements. Time lapse between a.m. and p.m. blood glucose measures: a.m. deviations were 20.6 points lower than p.m. measurements (p=0.001). Each additional minute was associated with an increase in blood glucose deviation by 0.39 points (p<0.0001). No difference by insulin type was noted. Discussion This study demonstrated timing of blood glucose measurement does affect the required SSI dose. The closer the blood glucose was obtained to the patient's meal time, the lower the glucose value (lower insulin requirement). Results suggest BG value and insulin dose administration should be accomplished immediately prior to meal time. [ABSTRACT FROM AUTHOR]

The article discusses a study evaluating the incidence of work-related foot pain or discomfort among registered nurses (RNs) and factors associated with it. A survey on 502 nurse participants revealed that factors that cause increased stress on structures of the foot included weight, age, nursing activity, floor surface of care unit, and certain aspects of choice of shoes. Some recommendations on addressing foot pain among RNs are highlighted.

As blood products are being used more judiciously, registered nurses need to develop practices to facilitate the effective administration of these products. The study results suggest both the syringe push method and the continuous infusion method of normal saline provide adequate line patency during packed red blood cell infusions through peripheral catheters. [ABSTRACT FROM AUTHOR]

This descriptive convenience study used a card sort technique to determine the self-identified cardiovascular health care needs of 81 female patients as compared to those identified as most important by their health care providers. [ABSTRACT FROM AUTHOR]