PSUN145 Nursing Perception of Implementation of Continuous Glucose Monitoring Technology in Patients with Hyperglycemia During the COVID-19 Pandemic
Authors: Talley Paula , Wood Jessica , Turner-Sotelo Kelly , Lozada Alejandra , Le Trang , Celi Francesco 
Published: November 2022

Abstract

Introduction
During the COVID-19 pandemic, the FDA began allowing hospitals to use continuous glucose monitoring (CGM) on a "non-objection" basis in the inpatient setting to decrease direct patient contact and preserve personal protective equipment while increasing the availability of glucose date to inform patient management decisions in April of 2020. Our institution deployed CGM technology (Dexcom ™) in 55 patients across four inpatient hospital units beginning September 2020, with a median use of 6.5 days per patient.

Objective
To explore perceptions and experience of nursing staff related to the use of CGM technology in patients with hyperglycemia admitted for COVID-19.

Methods
A qualitative survey was distributed to 29 critical care nurses who routinely utilized CGM technology to obtain and interpret glucose trends impacting clinical decisions for patients during their admission with COVID-19. The survey included eight questions that used a 1 to 5 scale format, where 1 corresponds to "strongly disagree" and 5 corresponds to "strongly agree", and two open-ended questions (advantages and concerns).

Results
100% of the respondents "agree" or "strongly agree" that CGM technology is useful in glucose management and prefer when their patient has a CGM. 97% "agree" or "strongly agree" that CGM technology is user-friendly and its use minimized direct patient interaction or contact, thereby reducing utilization of personal protective equipment (PPE). 93% "agree" or "strongly agree" that they feel confident operating a CGM device and consider the CGM data reliable and accurate. 90% "agree" or "strongly agree" that the technical aspects of CGM technology are easy to manage and would like to see this technology offered to patients without COVID. The most significant benefits of CGM as rated by the survey participants include: fewer fingersticks, decreased COVID exposure, convenience, PPE preservation, continuous glucose monitoring, and improved glycemic management. Concerns include: calibration time, accuracy, potential malfunction, extended warm-up period, and protocol education.

Discussion
This survey demonstrates that CGM technology previously primarily used in the outpatient setting can be easily adapted for inpatient use.Nurses eagerly accepted and competently integrated CGM technology into routine patient care, which, in turn, decreased exposure time in COVID-19 rooms and subsequently decreased PPE use. Proper education related to inpatient use of CGM technology and open communication between the nursing staff, the primary care team, and the endocrine consulting team have been identified as critical elements for a successful deployment and continued utilization.The use of inpatient CGM technology holds promise for improved glycemic control in hospitalized patients while increasing the safety of healthcare workers. Further studies demonstrating decreased exposure times and infection rates among healthcare workers caring patients with COVID-19, and measurable improvements in glycemic control in patients utilizing CGM technology should be explored to further demonstrate the benefits of inpatient CGM use.
Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.