%0 Journal Article
%T An Investigation of the Glucose Monitoring Practices of Nurses in Stroke Care: A Descriptive Cohort Study
%A Elizabeth Ann Laird
%A Vivien E. Coates
%A Assumpta A. Ryan
%A Mark O. McCarron
%A Diane Lyttle
%A David Chaney
%J Nursing Research and Practice
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/715802
%X Glucose derangement is commonly observed among adults admitted to hospital with acute stroke. This paper presents the findings from a descriptive cohort study that investigated the glucose monitoring practices of nurses caring for adults admitted to hospital with stroke or transient ischaemic attack. We found that a history of diabetes mellitus was strongly associated with initiation of glucose monitoring and higher frequency of that monitoring. Glucose monitoring was continued for a significantly longer duration of days for adults with a history of diabetes mellitus, when compared to the remainder of the cohort. As glucose monitoring was not routine practice for adults with no history of diabetes mellitus, the detection and treatment of hyperglycaemia and hypoglycaemia events could be delayed. There was a significant positive association between the admission hospital that is most likely to offer stroke unit care and the opportunity for glucose monitoring. We concluded that adults with acute stroke, irrespective of their diabetes mellitus status prior to admission to hospital, are vulnerable to both hyperglycaemic and hypoglycaemic events. This study suggests that the full potential of nurses in the monitoring of glucose among hospitalised adults with stroke has yet to be realised. 1. Introduction Nurses have a substantial role in the assessment and monitoring of adults admitted to hospital with stroke. Research has indicated that nurse-led interventions, including enhanced monitoring and management of glycaemia in the acute phase of stroke, mediate towards a positive clinical outcome after stroke [1]. Diabetes mellitus is a major risk factor for stroke, and impaired glucose tolerance and impaired glucose metabolism, intermediate conditions to type 2 diabetes, are contributing risk factors [2]. Whilst up to one-third of adults admitted to hospital with acute stroke may have a history of diabetes mellitus, hyperglycaemia is also commonly observed among those with no such history [3]. Transient patterns of hyperglycaemia that revert spontaneously to normoglycaemic ranges within 48 hours are indicative of a stress or inflammatory response [4, 5]. In contrast, patterns of delayed hyperglycaemia and persisting hyperglycaemia are most likely explained by the presence of diabetes or prediabetes syndromes [6¨C11]. Glucose regulation after stroke is a complex area [12¨C15]. The focus of this paper is glucose monitoring practice in stroke care. Internationally respected clinical guidelines [16¨C19] have consistently recommended that glucose is monitored when adults
%U http://www.hindawi.com/journals/nrp/2013/715802/