Conflicts of interest: The authors have no personal or financial relationships to disclose relevant to this article.
Audit of a clinical guideline for neonatal hypoglycaemia screening
Article first published online: 24 JUN 2013
© 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians)
Journal of Paediatrics and Child Health
Volume 49, Issue 10, pages 833–838, October 2013
How to Cite
Sundercombe, S. L., Raynes-Greenow, C. H., Carberry, A. E., Turner, R. M. and Jeffery, H. E. (2013), Audit of a clinical guideline for neonatal hypoglycaemia screening. Journal of Paediatrics and Child Health, 49: 833–838. doi: 10.1111/jpc.12293
- Issue published online: 17 OCT 2013
- Article first published online: 24 JUN 2013
- Manuscript Accepted: 9 APR 2013
- Australian National Health and Medical Research Council (NHRMC). Grant Number: #633003
- Australian Postgraduate PhD award
- clinical audit;
- clinical guideline;
- guideline adherence;
- infant (newborn)
This study aims to evaluate adherence to a clinical guideline for screening and prevention of neonatal hypoglycaemia on the post-natal wards.
Retrospective chart review of 581 healthy term neonates born at a tertiary maternity hospital. Indications for hypoglycaemia screening included small for gestational age (SGA), infants of diabetic mothers (IDM; gestational, Type 1 or 2), symptomatic hypoglycaemia, macrosomia and wasted (undernourished) appearance. Outcomes were protocol entry and adherence with hypoglycaemia prevention strategies including early and frequent feeding and timely blood glucose measurement.
Of 115 neonates screened for hypoglycaemia, 67 were IDM, 19 were SGA (including two both IDM and SGA), and two were macrosomic. One IDM and one SGA were not screened. Twenty-two neonates were screened for a reason not identifiable from the medical record, and 13 neonates were SGA by a definition different to the guideline definition, including five who were also IDM. Guideline adherence was variable. Few neonates (41 of 106, 39%) were fed in the first post-natal hour, and blood glucose measurement occurred later than recommended for 41 of 106 (39%) of neonates.
Most IDM and SGA neonates were screened. While guideline adherence overall was comparable with other studies, neonates were fed late. We recommend staff education about benefits of early (within the first hour) frequent breastfeeding for neonates at risk.