Collaborative development of an insulin nomogram for intensive insulin therapy.

A significant reduction in morbidity and mortality can be achieved by using intensive insulin therapy to achieve normoglycemia in the critically ill patient. Nurses hourly titrate insulin infusion rates using protocols, most often in chart form, to guide practice. Despite the reported development of several intensive insulin protocols, information about the accuracy, practicality, ease of calculation, and preferences of critical care nurses have not been studied.