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. 2021 Jan 27;27(4):354–361. doi: 10.1016/j.eprac.2021.01.011

Table 4.

Nursing CGM Implementation Themes, Subthemes, and Supporting Nursing Statements Within the PARIHS Framework for Facilitation

Theme Subtheme Exemplar statement
Barriers & recommendations EHR & technology integration
  • I think just having a place to chart it (CGM glucose) would be nice. Because right now, they have to put a notation in under the column. (MICU Nurse Manager, Participant 2)

  • Like, there were the papers that go with it. And it plugged in under the - our desks….It’s like cords everywhere. And I’m like - we’re all very Type A and clean, we like organized things. It was just kind of a lot of stuff. And it didn’t really have its own like spot to sit, which kind of drove me nuts. So. (MICU Staff RN, Participant 4)

Protocol simplification
  • Simple steps some, you know, instead of all–(MICU Nurse Manager, Participant 2)

  • Lots of words. Yeah. Less words. But like a Cliff’s Notes version. (MICU Staff RN, Participant 6)

  • I think there was one I got called. Oh, it’s - not in 20 - you know, one note at 20%. And I’d look, and I’m like, “Okay. So, here’s your number.” “And we’re going to times that by 20%. We’re going to add it. Oh my gosh. Yes, it is in range.” “Oh, yeah. I guess it is.” I think those are some of the people that didn’t read the protocol. (MICU CNS, Participant 5)

  • Like day shift, we have it. We set it up, it’s all good. And then you, you say (to night shift), “Oh, you have this CGM. And here’s what you have to do. And here’s how you calculate the changes.” And it was like a whole thing that you have to explain to the incoming shift. And then there’s people - like I don’t know - maybe they’re not good with percentages and fractions. (MICU Staff RN, Participant 4)

CGM insertion
  • I think I see maybe charge nurses initially being able to do it. Like every charge nurse getting education on that. And inserting a sensor maybe initially. I don’t know that every nurse in the MICU needs to - to know to do it right now. (MICU CNS, Participant 5)

  • I think our nurses are doing a lot more difficult tasks every day than placing a continuous glucose monitor. (MICU Nurse Manager, Participant 2)

Abbreviations: CGM = continuous glucose monitoring; CNS = clinical nurse specialist; COVID = coronavirus disease; EHR = electronic medical record; MICU = medical intensive care unit; NP = nurse practitioners; PARIHS = Promoting Action on Research in Health Services.