# Reducing inappropriate inpatient blood glucose monitoring

## TL;DR

This paper shows how targeted education and clear guidelines can significantly reduce unnecessary blood glucose monitoring in hospitals, saving costs and nursing time without harming patient safety.

## Contribution

The study introduces a multidisciplinary approach combining root-cause analysis, education, and guideline implementation to reduce inappropriate blood glucose monitoring.

## Key findings

- Inappropriate blood glucose monitoring decreased from 49.5% to 9.2% over 7 months.
- Annual savings of S$564,818.80 and 663.4 nursing hours were achieved without increasing adverse events.

## Abstract

Inpatient blood glucose monitoring (BGM) is prevalent, while healthcare costs and workforce demands are rising. We aimed to identify causes of unnecessary monitoring and assess effectiveness of targeted interventions, to maximise healthcare resources while prioritising patient safety.

Clinical guidelines were established with the Endocrinology division. A root-cause analysis revealed different factors, which were targeted through the plan, do, study, act methodology. Education and raising awareness were provided to staff. Guidelines were summarised into emails and stickers. Data were collected after each intervention, to monitor inappropriate monitoring rates and adverse events (hypoglycaemia and hyperglycaemia).

Results revealed a reduction of inappropriate BGM from 49.5% to 9.2% over 7 months, with no significant change in adverse events, with estimated annual savings of S$564,818.80 (£421,185.38) and 663.4 nursing hours hospital-wide. This highlights the effectiveness of clear guidelines, targeted multidisciplinary education to bridge gaps and empower staff to collaborate for patient-centred, high-value care.