Development of a graphic blood glucose monitoring chart for glycaemic control in diabetes mellitus: a modified Delphi method study

Background: In Kenya 30% of patients admitted with ketoacidosis due to hyperglycaemia die within 48 hours of hospitalisation. Effective monitoring of blood glucose levels is critical for glycaemic control and prevention of mortality. Kenya public hospitals lack a graphic blood glucose monitoring tool. Aims: To develop a graphic blood glucose monitoring tool. Methods: Modified Delphi technique was used for consensus-building among nurses on the features of an appropriate blood glucose monitoring tool. A total of 150 nurses selected by purposive sampling participated in the study. Data were collected for 24 months through sequential interactive rounds and workshops using a questionnaire. At every round, consensus was reached if ≥75% of the nurses agreed or disagreed on a feature. Results: A graphic blood glucose monitoring chart was developed with the following features: time on the x-axis, blood glucose values on the y-axis, colour codes corresponding to blood glucose levels, existing conditions during blood glucose measurement. Significance: The chart may improve glycaemic control while stimulating further research on its effectiveness. Conclusion: Modified Delphi method is useful for successive collation of judgments of nurse experts in the development of a graphic blood glucose monitoring chart.