Management of neonatal hypoglycaemia in a tertiary maternity unit-A multidisciplinary quality improvement project

Area of Science:

• Neonatal Medicine
• Quality Improvement Science
• Evidence-Based Practice

Background:

• Neonatal hypoglycemia poses a significant risk to infants.
• Effective identification and treatment strategies are crucial for improving neonatal outcomes.
• Existing guidelines require continuous evaluation and improvement.

Purpose of the Study:

• To improve the identification and treatment of infants at risk of hypoglycemia.
• To implement evidence-based guidelines in a tertiary maternity hospital setting.
• To reduce neonatal unit admissions and associated interventions.

Main Methods:

• A prospective, multidisciplinary quality improvement project (QIP) utilizing Plan-Do-Study-Act methodology.
• Implementation of hospital-wide initiatives including staff and antenatal maternal education, and standardization of equipment.
• Continuous evaluation and updating of guidelines based on emerging evidence and ongoing audits.

Main Results:

• Neonatal unit admissions decreased by 70% (from 3% to 0.9%).
• The need for intravenous (IV) glucose bolus reduced from 25% to 6%.
• Glucose gel use decreased by 94%, with no reported adverse effects.

Conclusions:

• The quality improvement project significantly reduced neonatal unit admissions, IV glucose, and glucose gel use.
• Initiatives led to cost reductions, decreased workload, less maternal-infant separation, and supported breastfeeding.
• These low-cost, evidence-based interventions are transferable to other tertiary maternity hospitals.