Date of Publication


Project Team

Jean Pelski, University of Vermont


Blood Glucose Telemonitoring Lessons Learned from a Quality Improvement Initiative

Jenna Smith, BS, DNPc, RN

DNP Project Advisor: Jean Pelski, PhD, APRN, NNP-BC

Agency Mentor: Kimberly Cowan, BA

Background: Uncontrolled diabetes contributes significantly to morbidity and mortality in Vermont. Patients with suboptimal glycemic control require ongoing blood glucose monitoring and timely titration of medications by a healthcare provider. Remote monitoring of blood glucose readings, or “telemonitoring,” is associated with significant improvements in glycemic control, reducing risk for adverse outcomes and hospitalization. This project aimed to establish and evaluate a standardized workflow strategy for telemonitoring patients with suboptimal glycemic control at an outpatient endocrinology clinic associated with a major academic medical center in Vermont.

Methods: Participants included patients with type 1, type 2, or gestational diabetes. An order set for telemonitoring was integrated into the electronic health record, allowing providers to request remote blood glucose monitoring. A clinic workflow was devised to manage notifications.

Results: Ten staff members completed a satisfaction survey. Sixty-six percent found the order set easy to use and were satisfied with it, while 83% found it functional for clinic needs. Similarly, 83% regarded the workflow as straightforward, logical, and functional, but only 50% were satisfied with it.

Conclusion/Implications: Technological difficulties and delays led to a lack of blood glucose data for review. Future steps should include evaluating blood glucose trends after telemonitoring, simplifying the telemonitoring ordering process, and providing additional staff training. The dissemination of quality improvement initiatives enriches the literature and informs future projects aiming to implement and sustain meaningful changes in healthcare delivery.

Document Type


Available for download on Tuesday, April 14, 2026

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Nursing Commons