Nurses' perceptions of glycemic control in patients who have undergone cardiac surgery.

Background/significance: Previous work investigating the effect of glycemic control in patients who underwent cardiac surgery has demonstrated that obtaining and maintaining blood glucose values between 80 and 120 is imperative in achieving excellent clinical outcomes in a patient who have undergone cardiac surgery. However, the caregiver's workload associated with meeting this goal is only now beginning to be understood.

Methods: This qualitative study used focus groups held on 3 consecutive days to interview nurses in the cardiovascular intensive care unit and cardiovascular step-down unit about their thoughts on glycemic control.Three research questions were developed to help guide the focus group discussions.

Results: Ten nurses, 3 from cardiovascular intensive care unit and 7 from cardiovascular step-down unit, participated in the focus groups and saturation was accomplished. The essence of the nurses' message was that they recognize glycemic control as a very important part of their patient care. However, to be able to perform this intervention, they need available equipment, a designated person to obtain all blood glucose values, periodic updates on patient outcomes related to glycemic control, and a less intrusive way to draw the patients' blood.

Conclusion: The ability of the nurses to obtain glycemic control is hindered by the lack of time, lack of necessary resources/equipment, lack of knowledge about the long-term outcomes resulting from glycemic control, and the discomfort to patients caused by the frequent blood draws. Hospitals need to investigate alternative mechanisms that will assist the nurse in meeting this goal.