Objective To understand the status and contents of current nursing practice in the management of blood glucose in critically ill adult patients in China. Methods From September 2021 to April 2022，an 8-month non-participatory observation of glucose management practice in the intensive care units of four tertiary care hospitals in Chongqing was conducted using field research. Quantitative data were collected using the ICU patient glucose management profile form and nursing staff glucose management practice record form. We repeatedly read the field notes and summarized existing nursing practices and existing problems in current blood glucose management nursing practices，further categorized and conducted in-depth analysis of the data. Results All four field observation sites had paper-based insulin infusion protocols，and the mean duration of the use of the protocols was（9±2.92） years，and the contents of the protocols differed across the fields. A total of 60 hyperglycemic patients were observed，and there were no statistically significant differences in the duration of hyperglycemia，the time required to reach target blood glucose level，and the maintenance of the target blood glucose range among patients from different field sites. The main tasks of the 12 nurses in glucose management included insulin infusion and adjustment，glucose monitoring，patient nutrition management，and hypoglycemia treatment. However，there was still a gap with the best evidence on blood glucose monitoring method，insulin use，whether nutritional support should be combined with insulin infusion，etc. Conclusion Nursing staff need to enhance their clinical decision-making skills，and further construct and implement a comprehensive and standardized practice plan for glucose management in critically ill adult patients based on the best evidence. This is a main solution to address current glucose management practice issues in the field sites.