COLUMBUS, Ohio — It was March 2020, and the COVID-19 pandemic was just starting to rage at hospitals across the country and at The Ohio State University Wexner Medical Center.
“We became very concerned because we knew that these patients with COVID-19, they were incredibly ill,” said Eileen Faulds, assistant professor at the OSU College of Nursing and endocrinology nurse practitioner at the OSU Wexner Medical Center. “We knew that if you had a diagnosis of diabetes you were more likely to develop critical illness if you did get COVID-19. And then, when you are critically ill, having good blood glucose control is incredibly important, so we knew these patients needed IV insulin, so they needed a continuous infusion of IV insulin.”
That required nurses to do a finger prick every hour. It was time-intensive but also required nurses to put themselves in a potentially dangerous situation. All of this was happening at a time when much was still being learned about the spread of COVID-19.
“That was really the most difficult thing I believe from my aspect because we’re trying to keep the bedside nurses safe, and how can you keep them safe if you don’t really know what you’re facing,” said Laureen Jones, clinical nurse specialist for the Medical Intensive Care Unit at OSU Wexner Medical Center.
So the nurses put their brains to work to come up with a possible solution. They landed on trying to use continuous glucose monitoring devices, which at that point were only FDA-approved for outpatient use, on their COVID-19 patients with high blood sugar. This would allow for the continuous monitoring of levels and administering of insulin from outside of the patient’s hospital room, keeping the nurses safe and saving PPE.
“The nurses at the bedside, they know what’s going on, they know how to do things,” Jones said. “They are the most, I don’t even know the word I want, ingenious, the things that nurses can come up with, you talk about MacGyvering.”
Things moved quickly from there. The idea arose in late March 2020, the FDA allowed it in early April, and, by early May, the nurses at OSU were using the protocol on their first patient.
“In health care, we tend to be very cautious, and we tend to move really, really slowly, for really good reason,” Faulds said. “But this was such a time of remarkable adaptation, innovation, collaboration within medicine that I’ve never seen before, within nursing.”
Since implementation, the frequency of bedside testing has been reduced by 71% for more than 100 critically ill COVID-19 patients.
And that work did not go unnoticed. Just last month, the team behind the innovation won the 2021 ANCC Magnet Prize. It’s an international recognition. And Faulds said this was the first time in the award’s history that the judges unanimously agreed on a winner.
“This has been a nursing innovation,” she said. “Nurses are choosing the patients that get it, nurses are placing the devices, they’re effectively using the systems, and that’s been the most inspirational thing about this whole thing is that it’s really been encapsulated within nursing.”
And having a moment to celebrate a win after a tough two years meant a lot to the staff involved. The innovation from the nurses is now being used in dozens of other health systems across the country. And the hope is to expand the protocol to non-COVID patients.
“Just seeing their faces, it was pretty special, it was really, really, really something special,” Jones said of the awards ceremony. “I feel like we are on the edge of innovation and research, and we’re always going the extra mile to do things for the safety and well-being for our patients and actually also for our nursing staff.”