Redefining Inpatient Diabetes Care: A Policy-Driven Approach to Safe and Effective Technology Use
Document Type
Article
Subject Area(s)
Humans; Insulin Infusion Systems (standards); Female; Male; Middle Aged; Diabetes Mellitus (drug therapy); Inpatients (statistics & numerical data); Blood Glucose Self-Monitoring (methods); Aged; Surveys and Questionnaires; Blood Glucose (analysis); Adult; Insulin (therapeutic use); Patient Satisfaction; Southeastern United States
Abstract
BACKGROUND:
Patients with diabetes are using advanced diabetes self-management technology, such as integrated insulin pumps with continuous glucose monitors (CGM) during hospitalization. Concerns surround their use in the inpatient setting ranging from safety risks to provider and nursing comfort in overseeing these devices.
LOCAL PROBLEM:
At a 332-bed hospital in the Southeastern United States, the inpatient insulin pump policy did not support current evidence-based clinical recommendations.
METHODS:
An updated policy was designed, allowing patients to continue using automated insulin pumps during hospitalization. Pre- and postpolicy nursing knowledge surveys, patient glucose metrics (including mean Glucose and Time in Range of 70-180 mg/dl), and patient narratives were evaluated to determine if the inpatient policy maintained optimal glucose control, improved patient satisfaction, and increased nursing comfort levels.
INTERVENTIONS:
The updated policy was applied to all patients admitted using automated insulin pumps over 19 weeks. Nursing education was provided on the new policy release.
RESULTS:
Mean glucose was 153.6 mg/dl for time segments on automated insulin pump, versus 201.4 mg/dl for stand-alone insulin pump without CGM and 262.3 mg/dl with subcutaneous insulin injections. Time in range was achieved at 72.1% (goal >70%) for time segment patients continued automated insulin pump, versus 44.3% insulin pump without CGM and 31.7% on subcutaneous insulin injections. Five of nine realms on the postnursing survey showed significant improvement ( p < .05).
CONCLUSIONS:
Applying an evidence-based policy that allows patients to remain on their automated insulin pump during hospitalization maintains glycemic control and patient satisfaction, as well as improves nursing comfort levels.
Digital Object Identifier (DOI)
Publication Info
Published in Journal of the American Association of Nurse Practitioners, Volume 38, Issue 1, 2026, pages 47-55.
APA Citation
Holliday, M. E., Herbert, L., & Kubas, J. (2026). Redefining inpatient diabetes care: A policy-driven approach to safe and effective technology use. Journal of the American Association of Nurse Practitioners, 38(1), 47–55. https://doi.org/10.1097/JXX.0000000000001209
Rights
© 2025 American Association of Nurse Practitioners