NURS 6052 Week 7 Assignment; Critical Appraisal of Continuous Glucose Monitors (Part 3B)

Critical Appraisal of Continuous Glucose Monitors A. Wainwright Masters of Science in Nursing, Walden University NURS 6052, Section 4, Essentials of Evidenced-Based Practice Dr. Ming August 13, 2025 Introduction to Critical Appraisal The integration of continuous glucose monitors (CGMs) into the hospital setting represents a potentially transformative step in inpatient diabetes management. Traditionally, capillary blood glucose testing remains the standard approach for monitoring glucose levels in hospitalized patients. However, the adoption of CGMs, originally designed for outpatient use, offers several advantages, alongside notable challenges that warrant careful consideration. The purpose of this paper is to critically appraise the use of CGMs in the inpatient setting and present research that reaps the benefits of this best practice. Benefits of CGM Implementation One of the primary advantages of CGMs is their ability to provide real-time, continuous data on a patient’s glucose trends. This frequent monitoring reduces the likelihood of undetected hypo or hyperglycemic episodes, particularly in critically ill or insulin-dependent patients, where tight glycemic control is essential (Cavalcante et al., 2025). Moreover, CGMs can alert healthcare providers to impending glycemic excursions, enabling timely interventions and potentially improving clinical outcomes. Additionally, CGMs can reduce the burden on nursing staff. Frequent fingerstick checks, often required multiple times per shift, are time-consuming and can be uncomfortable for patients. By contrast, CGMs can provide round-the-clock data with fewer interruptions, potentially enhancing patient comfort and workflow efficiency (Galderisi et al., 2021). Evidence is the foundation of research as it transforms ideas, observations, and questions into reliable knowledge (Melnyk et al., 2010). Emerging evidence has demonstrated the feasibility and safety of CGMs in the inpatient setting. Polsky (2020) supports this idea by showcasing evidence on improved glycemic control in type 1 diabetic pregnant women who wore CGMs. Critically appraising this evidence provides the framework for initiating CGMs as best practice into inpatient settings (Williamson, (2009). Challenges and Limitations Despite their promise, several challenges complicate the widespread adoption of CGMs in hospitals. One of the foremost concerns is accuracy. CGMs measure interstitial rather than blood glucose, and their accuracy can be compromised in critically ill patients, particularly those with poor perfusion, edema, or receiving vasopressors. Maiorino et al. (2020) evaluates research that addresses these challenges as limitations in their study but overall recommends the use of CGM use. However, reliance solely on CGM data is not sufficient per Simunovic (2024). The combination of CGM use and capillary testing is identified as best practice in both studies. Additionally, cost remains an important consideration. While CGMs may reduce long-term healthcare costs through better glycemic control, the initial investment in devices, training, and infrastructure can be substantial (Lacy et al., 2024). Hospitals must balance t