Nurse Perceptions of Providing Continuous Blood Glucose Data for a Research Study

Abstract: Title: Nurse Perceptions of Providing Continuous Blood Glucose Data for a Research Study Background: Acute care nurses are essential to preserve quality and quantity of life of hospitalized patients. However, nurses present with a higher risk of type II diabetes compared to other licensed healthcare providers, especially if assigned to night shifts, despite controlling for modifiable lifestyle factors such as diet and exercise. Laboratory studies suggest that eating during the night hours may cause an aberrant glucose response. It is hypothesized that consistently eating a meal during night hours may provide one mechanism for increased risk of type II diabetes development among night shift workers, yet field studies confirming these relationships are lacking. Studies collecting accurate blood glucose measures may help inform innovative strategies to preserve the health of registered nurses. Purpose: To describe nurse perceptions of participation in a continuous blood glucose study. Methods: Frontline, 12-hour shift nurses who were not pregnant/breastfeeding or suffering pre/diabetes and working on one of two adult intensive care units at a large medical center in the Pacific Northwest were invited to participate in this observational study. Interested nurses were directed to complete an online screening form, with the option to e-consent if eligibility criteria were met. Once consented, nurses were instructed to meet with research staff on the last off-duty day before working 3, consecutive shifts followed by 4 off-duty days. During onboarding, research staff inserted a continuous glucose monitor (CGM) on the participant as well as an activity monitor and provided a printed “to-do list” to ensure protocol compliance. Participants returned the activity monitor and had CGM data uploaded at the end of the 4th off-duty day and completed a questionnaire on experiences participating in the study. Results: Out of approximately 152 nurses on the units, 62 (40.8%) self-screened, 61 were eligible, and 49 provided consent. In all, 12-night shift and 10-day shift nurses coordinated the correct schedule and completed the protocol. Participants unanimously rated the CGM as extremely easy to use and 19 out of 20 (95%) reported they would be willing to participate in a similar study in the future. Open-ended feedback from participants were very positive toward the study, with quotes such as: “Devices were comfortable and did not interfere with clothing or exercise.” “It (the study) was easy and didn\u27t require a lot of work.” “I’m excited to find out what my glucose was throughout the study.” “The activity monitor and CGM were set it and forget it.” Conclusion: Frontline nurses demonstrated substantial interest in a study collecting CGM data. Most study participants rated the device as extremely easy to use and would participate in another similar study. A barrier to this study was the required shift schedule of 3 consecutive shifts, followed by 4 off-duty days. Future studies should consider allowing variable shift sequences. Implications for Practice: Understanding the impact of night shift work on acute and chronic changes to blood glucose is imperative to mitigate risk for diabetes. Our study suggests that collecting these data from frontline, critical care nurses using a subcutaneously-attached CGM is feasible, simple, and reproducible