Improving Inpatient Continuous Glucose Monitoring Documentation Through Targeted Nursing Education

To evaluate whether a targeted nursing education intervention improved adoption of a standardized electronic medical record (EMR) documentation workflow for patient-reported continuous glucose monitoring (CGM) values among hospitalized adults with diabetes.

We conducted a retrospective pre-post quality improvement study at a 1,131-bed academic institution. Adults aged ≥18 years with type 1 or type 2 diabetes admitted with a functional CGM were included. Pre-intervention data (7/21/24-11/21/24) were compared with a 5-month post-intervention period (11/21/24-04/21/25) following implementation of a nursing practice alert and education initiative. The primary outcome was the proportion of patients with at least 1 CGM value documented in the designated "Patient Performed Glucose" flowsheet.

A total of 224 patients were included (34% type 1, 66% type 2 diabetes) in the primary analysis, and 222 patients were included in the pre-post comparison (94 pre-intervention and 128 post-intervention). Mean age was 63±15 years and median HbA1c 7.4% (IQR 6.4-8.4). Documentation rates increased from 54.3% pre-intervention to 68.8% post-intervention (χ² p=0.0389). Average documented CGM readings per day did not differ pre- and post-intervention. Among documented readings, level 2 hypoglycemia decreased from 0.47% to 0.19%, whereas hyperglycemic readings increased from 30.8% to 35.1%.

A targeted, low-cost nursing education intervention was associated with improved adoption of a standardized inpatient CGM documentation workflow. Further studies are needed to establish optimal documentation practices and determine their clinical impact.