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Updated: Apr 24, 2026

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Sweeter recovery, less intravenous fluids: a NICU quality improvement initiative for managing neonatal hypoglycemia
Rachel Reed1, Andrea Weintraub1, Richelle Reinhart2
1Division of Newborn Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Background:
Neonatal hypoglycemia is a common reason for neonatal intensive care unit (NICU) admission. Management variations may prolong intravenous (IV) dextrose use and NICU length of stay (LOS).
Methods:
We aimed to reduce IV dextrose duration for hypoglycemic neonates transferred to the NICU by 30%. Standardization efforts included multidisciplinary team formation, guideline development, Epic SmartPhrase creation, and education. Our primary outcome measure was IV dextrose infusion duration. Secondary outcomes were LOS, percentage of patients started on IV dextrose, and number of blood draws. The process measure was guideline utilization. Balancing measures were readmissions, second IV courses, and dextrose boluses.
Results:
Mean IV dextrose administration decreased from 25 to 16 h and LOS from 59 to 27 h. The number of blood draws and boluses decreased without changes in readmissions or second IV dextrose courses.
Conclusions:
Our quality initiative safely reduced IV dextrose duration and NICU LOS, without significant rebound hypoglycemia.
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