Three is Better Than Two: Dose-related Efficacy of Dextrose Gel for Neonatal Hypoglycemia in At-Risk Infants, a Quality Improvement Initiative.
Academic Article
Overview
abstract
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.
