Date of Graduation
Project/Capstone - Global access
Master of Science in Nursing (MSN)
School of Nursing and Health Professions
Dr. Elena Capella
Problem: Diabetic patients utilize treatments that require frequent monitoring and medication changes based on their blood sugar results. Continuous Glucose Monitoring (CGM) is more commonly used for diabetes management as time in range is becoming more prevalent to measure diabetes outcomes. Many diabetic patients find CGM use more accessible than finger sticks and glucometers. In contrast, others utilize the technology to closely monitor their blood sugars for interventions throughout the day. However, older adults have difficulty facilitating new CGM technology and may require further reinforcement using additional education methods such as teach-back.
Context: The endocrinology clinic serves a patient population, primarily diabetic patients who utilize treatments that require frequent monitoring and medication changes based on their blood sugar results. This clinic has deficits in patient care related to the initiation of patient continuous glucose monitoring devices (CGM). The current process delays patient care and impedes healthcare providers' work processes within the endocrinology and diabetes education clinics by limiting time dedicated to patient care.
Interventions: This problem was mitigated by creating a foundational baseline for the CGM process from the point of prescription to the point of use or evaluation, reviewing the standardized CGM process using the teach-back method with patients, and educating the clinic staff on the standardized process.
Measures: The measures utilized to monitor the study are the percentage of reduced clinic visit time dedicated to CGM set-up with providers and Diabetes Education Clinic, the reduction in time dedicated per provider per patient for CGM set-up in Endocrinology and Diabetes Education Clinic, and the clinic staff feedback with a detailed log of time dedicated for CGM device download and set-up time during clinic visits. An additional measure used is the evaluation of provider knowledge about the process, all through surveys throughout the quality improvement process.
Results: At the conclusion of the project, time dedicated to education during visits was reduced from 1.4 minutes to 1 minute on average, the percentage of office visit time lost was reduced from 6.5% to 1%, and the average number of correct answers for CGM access knowledge test increased from 2.9 to 3.8 out of 5, and overall percentage correct on the knowledge tests increased from 57% to 76%.
Conclusions: This intervention successfully met the expected goals by decreasing the percentage of office visit time dedicated to CGM education and increasing the overall staff knowledge of the CGM process. After the conclusion of this project, it is expected to continue in the clinic for use by healthcare providers and potentially expand to other primary care and hospital-based clinics.
Ildefonso, Colleen, "Enhancing Diabetic Patient Continuous Glucose Monitoring Access" (2023). Master's Projects and Capstones. 1574.