Aim A departmental audit conducted in 2004 showed poor adherence to the protocol for management of infants at risk of hypoglycaemia on the postnatal ward. A simplified user friendly protocol was introduced in 2005. We present the impact of this new protocol on the number of infants admitted to the neonatal unit with hypoglycaemia.
Method Information was obtained retrospectively from admission records. Infants with a diagnosis of hypoglycaemia, admitted from the postnatal ward or labour ward, were included. Information was also recorded on duration of admission. The period audited was the 4 years prior to, and the 4 years following, introduction of the protocol.
Results 222 neonates were admitted with hypoglycaemia (2.3% of live births) before introduction of the protocol compared to 78 infants (0.63% of live births) following the introduction. This is a remarkable 72% reduction in the number of hypoglycaemia admissions (p≤0.0001). Total days spent caring for infants with hypoglycaemia on the neonatal unit was reduced from 1609 days to 525 days.
Conclusion The dramatic reduction in the number of admissions following the introduction of the protocol has major implications. It helps reduce the cost of caring for these infants and, importantly, helps prevent unnecessary separation of the infant and mother during the crucial bonding period. This audit highlights that a thorough user friendly protocol can help to reduce hypoglycaemia admissions without the need for additional resources such as a transitional care unit.
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