Fewer glucose checks and decreased supplementation using dextrose gel for asymptomatic neonatal hypoglycemia

Area of Science:

• Neonatal Medicine
• Pediatrics
• Clinical Quality Improvement

Background:

• Neonatal hypoglycemia (NH) is a common concern in late preterm and term infants.
• Effective management strategies are crucial to prevent adverse outcomes.
• Clinical pathways can standardize care for NH.

Purpose of the Study:

• To evaluate the impact of a clinical pathway incorporating buccal dextrose gel for NH management.
• To assess changes in interventions for NH after pathway implementation.

Main Methods:

• Quality improvement study conducted at a children's hospital birth center.
• Compared data from a 16-month pre-implementation period to a 26-month post-implementation period.
• Tracked blood glucose checks, supplemental milk use, and IV glucose administration.

Main Results:

• 32% of 2703 screened infants received dextrose gel.
• Mean blood glucose checks per infant decreased from 6.6 to 5.6.
• Supplemental milk use dropped from 42% to 30%, and IV glucose need decreased from 4.8% to 3.5%.

Conclusions:

• A clinical pathway integrating dextrose gel effectively reduced interventions for NH.
• Sustained reductions were observed in supplemental milk and IV glucose requirements.
• Buccal dextrose gel is a valuable component of NH clinical pathways.