Date of Publication
Dr. Holly Whitcomb, DNP and Dr. Melanie Keiffer, DNP
BACKGROUND: Continuous glucose monitor (CGM) technology has shown to improve patient adherence rates for checking blood glucose levels and preventing T2DM progression and disease complications. However, clinician confidence in prescribing and monitoring CGM in the primary care setting has remained low.
PURPOSE: This project aimed to develop, implement, and evaluate an evidence-based protocol to assist clinicians in managing T2DM patients who use a CGM. The project aimed to improve and evaluate clinician confidence and competence in using the recommended protocol.
METHODS: A protocol was developed for monitoring CGM in a primary care setting. A CGM clinician competency checklist was developed to evaluate protocol compliance. An electronic health record (EHR) progress note template was created. A retrospective audit of compliance to competency checklist measures in the EHR was performed, and feedback was shared with clinicians. A pre- and post-Likert scale survey ascertained clinician confidence in prescribing and managing the use of the CGM.
RESULTS: In an audit of EHR notes (n=14) pre- and post-implementation of a progress note template, the mean documentation score increased from 15 percent to 93.8 percent. Documentation in all 20 items addressing best practices in CGM monitoring improved. An increase in clinician confidence occurred per the pre- and post-Likert survey.
CONCLUSIONS: Audit and feedback, development of a standard note template, and clinician competency checklist improved clinician competency over time. Integrating quality improvement practices into the clinic routine with periodic review of clinician documentation will sustain change.
Shepard, Patrick, "Optimizing Clinician Confidence & Competence in Monitoring Patient Use of Continuous Glucose Monitors" (2023). College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications. 126.
Available for download on Thursday, May 01, 2025