Implementation of a protocol to prevent hypoglycemia in at-risk neonates born at 35 weeks' gestational age in a tertiary hospital: Adherence and satisfaction. It's not so easy!
Adherence
Hypoglycemia
Neonates
Screening
Journal
Archives de pediatrie : organe officiel de la Societe francaise de pediatrie
ISSN: 1769-664X
Titre abrégé: Arch Pediatr
Pays: France
ID NLM: 9421356
Informations de publication
Date de publication:
28 Oct 2024
28 Oct 2024
Historique:
received:
23
03
2024
revised:
26
06
2024
accepted:
16
07
2024
medline:
30
10
2024
pubmed:
30
10
2024
entrez:
29
10
2024
Statut:
aheadofprint
Résumé
The present study assessed adherence and satisfaction regarding a new protocol for preventing hypoglycemia in neonates, with a target of 80 % adherence. This 6-month prospective observational study was conducted between 2021 and 2022 in a tertiary hospital maternity unit. Neonates with at least one hypoglycemia risk factor were included. Two factors for adherence were evaluated: feeding before 1 h of life and capillary blood glucose assay at 2 h of life. Protocol adherence was 67.6 % overall, with clinically satisfactory protocol application. Neonates small for gestational age were at the greatest risk of hypoglycemia (34.8 %). Non-adherence mainly concerned early feeding (28.9 %). The rate of hypoglycemia with adherence and non-adherence was, respectively, 15.8 % (n = 27/171) and 22.0 % (n = 18/82) (p = 0.23). Teams integrated the new recommendations successfully (satisfaction: 8/10), with some reluctance on the part of childcare assistants due to increased workload. This apparently simple protocol could be supported by a quality improvement program. This study might help other care teams to establish similar protocols and identify areas for improvement.
Sections du résumé
BACKGROUND
BACKGROUND
The present study assessed adherence and satisfaction regarding a new protocol for preventing hypoglycemia in neonates, with a target of 80 % adherence.
METHODS
METHODS
This 6-month prospective observational study was conducted between 2021 and 2022 in a tertiary hospital maternity unit. Neonates with at least one hypoglycemia risk factor were included. Two factors for adherence were evaluated: feeding before 1 h of life and capillary blood glucose assay at 2 h of life.
RESULTS
RESULTS
Protocol adherence was 67.6 % overall, with clinically satisfactory protocol application. Neonates small for gestational age were at the greatest risk of hypoglycemia (34.8 %). Non-adherence mainly concerned early feeding (28.9 %). The rate of hypoglycemia with adherence and non-adherence was, respectively, 15.8 % (n = 27/171) and 22.0 % (n = 18/82) (p = 0.23). Teams integrated the new recommendations successfully (satisfaction: 8/10), with some reluctance on the part of childcare assistants due to increased workload.
CONCLUSION
CONCLUSIONS
This apparently simple protocol could be supported by a quality improvement program. This study might help other care teams to establish similar protocols and identify areas for improvement.
Identifiants
pubmed: 39472215
pii: S0929-693X(24)00140-4
doi: 10.1016/j.arcped.2024.07.008
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024 Société française de pédiatrie. Published by Elsevier Masson SAS. All rights reserved.