Introduction and Objective: Guidelines endorse CGM use during hospitalizations with proper support. However, barriers and facilitators for optimal implementation in the pediatric hospital setting are unknown. We aimed to evaluate user experiences before and after implementing a pediatric hospital CGM policy.Methods: In September 2024, we implemented a hospital policy to support using personal CGM to reduce fingersticks. People with diabetes (PwDs) or their guardians, nurses, and non-endocrine providers (residents and advance practice providers) were surveyed about their experiences using CGM during hospital encounters before and after implementation. Surveys included custom Likert-scale and free response questions. Hospital staff also completed a modified System Usability Scale (SUS). SUS scores were compared using two-tailed t-tests.Results: Surveys were completed by 40 PwDs, 22 nurses, and 12 providers at baseline and 9 PwDs, 37 nurses, and 12 providers post-implementation. PwD satisfaction with hospital glucose management was high throughout (>90%). Post-implementation, PwDs reported increased confidence in nurses’ ability to use CGM, more preference for using CGM for insulin dosing, and fewer interruptions. SUS scores increased by 16.8 ± 5.0 (mean difference ± SE) for nurses (p=0.002) and by 13.1 ± 7.2 for providers (p=0.09). Staff reported improved perceptions about ease of use, system integration, consistency, and ability to learn the system quickly. Staff perception that CGM workflow adds unnecessary tasks remained a major barrier. Though PwDs and nurses both report high confidence in nurses’ ability to use CGM, both groups wanted more staff education.Conclusion: Implementation of a pediatric hospital CGM policy was associated with improved experiences for PwD and staff. Identifying and addressing barriers to user experience, along with assessment of CGM accuracy, safety events, and glycemic outcomes are needed to promote program sustainability.
M. Lee: None. H. Ortega: None. K. Belanger: None. S.M. Jones: None. J.J.H. Lee: None. C. Chow-Parmer: None. C. Suarez: None. D.M. Maahs: Advisory Panel; Abbott, Medtronic. Research Support; Dexcom, Inc. Consultant; Sanofi. P. Prahalad: Consultant; Sanofi. R. Lal: Consultant; Abbott, Biolinq, Capillary Biomedical, Inc, Gluroo, PhysioLogic Devices, Portal Insulin, Sanofi, Tidepool. Advisory Panel; Provention Bio, Inc, Provention Bio, Inc, Microbion, Microbion, Lilly Diabetes. Research Support; Insulet Corporation, Medtronic, Tandem Diabetes Care, Inc, Sinocare Inc. M.S. Hughes: Consultant; Dexcom, Inc. Research Support; Tandem Diabetes Care, Inc, Medtronic, Insulet Corporation, Sinocare Inc. S. Shah: Research Support; MannKind Corporation.
National Institute of Health (5K12DK122550-05, DK007217-47), Stanford Maternal & Child Health Research Institute
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