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!

Abstract

Background: The present study assessed adherence and satisfaction regarding a new protocol for preventing hypoglycemia in neonates, with a target of 80 % adherence.

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: 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: 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.

Keywords: Adherence; Hypoglycemia; Neonates; Screening.