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Aims/hypothesis The aim of this work was to assess the effectiveness of continuous glucose monitoring (CGM) vs selfmonitoring of blood glucose (SMBG) in maintaining glycaemic control among people with type 1 diabetes mellitus. Methods Cochrane Library, PubMed, Embase, CINAHL, Scopus, trial registries and grey literature were searched from 9 June 2011 until 22 December 2020 for RCTs comparing CGM intervention against SMBG control among the non-pregnant individuals with type 1 diabetes mellitus of all ages and both sexes on multiple daily injections or continuous subcutaneous insulin infusion with HbA 1c levels, severe hypoglycaemia and diabetic ketoacidosis (DKA) as outcomes. Studies also included any individual or caregiver-led CGM systems. Studies involving GlucoWatch were excluded. Risk of bias was appraised with Cochrane risk of bias tool. Metaanalysis and meta-regression were performed using Review Manager software and R software, respectively. Heterogeneity was evaluated using χ 2 and I 2 statistics. Overall effects and certainty of evidence were evaluated using Z statistic and GRADE (Grading of Recommendations, Assessment, Development and Evaluation) software. Results Twenty-two studies, involving 2188 individuals with type 1 diabetes, were identified. Most studies had low risk of bias. Meta-analysis of 21 studies involving 2149 individuals revealed that CGM significantly decreased HbA 1c levels compared with SMBG (mean difference −2.46 mmol/mol [−0.23%] [95% CI −3.83, −1.08], Z = 3.50, p=0.0005), with larger effects experienced among higher baseline HbA 1c >64 mmol/mol (>8%) individuals (mean difference −4.67 mmol/mol [−0.43%] [95% CI −6.04, −3.30], Z = 6.69, p<0.00001). However, CGM had no influence on the number of severe hypoglycaemia (p=0.13) and DKA events (p=0.88). Certainty of evidence was moderate. Conclusions/interpretation CGM is superior to SMBG in improving glycaemic control among individuals with type 1 diabetes in the community, especially in those with uncontrolled glycaemia. Individuals with type 1 diabetes with HbA 1c >64 mmol/mol (>8%) are most likely to benefit from CGM. Current findings could not confer a concrete conclusion on the effectiveness of CGM on DKA outcome as DKA incidences were rare. Current evidence is also limited to outpatient settings. Future research should evaluate the accuracy of CGM and the effectiveness of CGM across different age groups and insulin regimens as these remain unclear in this paper. PROSPERO registration Registration no. CRD42020207042.

Aims and objectives This study aims to explore nurses' perceptions and experiences regarding pressure injuries caused by medical devices and to understand the perceived challenges and barriers nurses face in preventing medical device‐related pressure injuries. Background Nurses have a responsibility to prevent pressure injuries and play a major role in their prevention. As there has been a lack of research on medical device‐related pressure injuries, not much is known about nurses’ perceptions and experiences. This therefore hinders the establishment of effective and efficient interventions in nurses’ education and in the practical environment. Design A descriptive qualitative design was adopted, and the COREQ checklist was employed to report on the current study. Methods The study was conducted at an acute care hospital in Singapore. Purposive sampling was used, and a total of 21 enrolled and registered nurses who had recent experiences with medical device‐related pressure injuries were recruited between August and December 2018. Face‐to‐face interviews were conducted using a semi‐structured interview guide. A thematic analysis was performed to analyse the qualitative data. Results Five themes emerged regarding pressure injuries: (1) preventable yet unavoidable, (2) everyone's responsibility, (3) harmonising theory with practice reality, (4) pre‐existing conditions may limit injury prevention and management; and (5) nurses expressed a need for experiential training. Conclusions The study's findings could be used to develop improvements in nursing practice and policy at acute care hospitals, as well as to improve awareness of medical device‐related pressure injuries among healthcare professionals. Moreover, the findings can also inform future research studies to develop effective evidence‐based practices and improve patient outcomes. Relevance to the clinical practice This study reveals the unique challenges and dilemmas that nurses face and will help to inform healthcare institutions and management in developing programmes and improving protocols to reduce the incidence rate of pressure injuries caused by medical device.

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