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Updated: May 13, 2025

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Three is Better Than Two: Dose-related Efficacy of Dextrose Gel for Neonatal Hypoglycemia in At-Risk Infants, a
Melanie Gao1, Jenny Jin2, Jillian Schon3
1Division of Newborn Medicine, NewYork Presbyterian-Weill Cornell Medicine, New York, NY, USA. Myg9011@nyp.org.
Objective:
Using a quality improvement (QI) framework, we aimed to use dextrose gel (DG) to reduce admissions for neonatal hypoglycemia by 20% and IV dextrose fluid needs by 10% in at-risk infants.
Methods:
This is a prospective QI study using the Model for Improvement and planned sequential experimentation through three Plan-Do-Study-Act (PDSA) cycles: pathway creation, EMR implementation, and dose increase. Data were analyzed using Shewhart P-charts and chi-square tests.
Results:
Our interventions increased the percentage of at-risk infants with hypoglycemia who received DG from 67% to 98%. Implementing three doses of DG caused a special cause variation, reducing neonatal hypoglycemia admissions from 3.7% to 2.0% and IV dextrose fluid rates from 2.7% to 1.7% (46% and 37% reduction, respectively).
Conclusion:
Three doses of dextrose gel administered to at-risk infants with neonatal hypoglycemia reduced the need for additional intervention, suggesting the dose-related efficacy of dextrose gel in mitigating the consequences of neonatal hypoglycemia.
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