C301_Translational Research.docx - Running head GLUCOSE GEL AS A PRIMARY TREATMENT Glucose Gel as a Primary Treatment for Neonatal Hypoglycemia Western

C301_Translational Research.docx - Running head GLUCOSE GEL...

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Running head: GLUCOSE GEL AS A PRIMARY TREATMENT 1 Glucose Gel as a Primary Treatment for Neonatal Hypoglycemia Western Governors University
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GLUCOSE GEL AS A PRIMARY TREATMENT 2 Glucose Gel as a Primary Treatment for Neonatal Hypoglycemia Professional Practice Description The Family Birth Center, which consists of the Labor & Delivery unit, the Mother/Baby unit, and the Neonatal Intensive Care Unit (NICU), is responsible for delivering and caring approximately 4,000 babies each year. With the growing diabetic population, there are an increasing number of newborns being delivered at risk for hypoglycemia. At risk is defined as infants born to diabetic mothers, small or large for gestational age, and late preterm. A newborn hypoglycemic policy and associated protocol with an algorithm exists to manage these at risk newborns. With our current protocols, the focus of maintaining stable blood sugar glucose (BSG) levels lessens the importance of exclusive breastfeeding and preventing the separation of the mother/newborn couplet. The current newborn hypoglycemic policy has the nurse obtain a blood sugar glucose (BSG) level 30 minutes after the completion of the first feeding. Infants experiencing hypoglycemia, defined as BSG level of < 35 mg/dl within the first two hours of life, are then fed as much formula from a bottle as the infant will tolerate. A recheck of the BSG level is done one hour after the completion of the follow-up formula feeding. The infant must now have a BSG level of >40 mg/dl to be considered stable and be transferred to the Mother/Baby unit with the mother. If the BSG level is <40 mg/dl, then the pediatrician is notified and further orders received. Depending on the actual BSG level, the pediatrician will either request the mother supplement the infant with formula every two hours for at least the first 24 hours of life or consult with the neonatologist about an admit to the NICU for intravenous dextrose. In an effort to support exclusive breastfeeding and prevent mother/newborn separation, a change needs to be made to the current protocol in the treatment of the hypoglycemic newborn.
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GLUCOSE GEL AS A PRIMARY TREATMENT 3 Key Stakeholders The current nursing practice for monitoring at risk newborns for hypoglycemia encompasses all units within the Family Birth Center at the hospital; Labor & Delivery, Mother/Baby, and NICU. At the top is the Director of Women’s Health, the Director of Neonatology, a Unit Manager for each of the three units, two Nurse Educators, the lactation consultants, and nurses from each of the three units. As a final step in all of our current nursing practice policies, our legal advisor approves the written document. A majority of the practice change committee will be composed of the nurses from all three units, as these nurses will be involved in the direct patient care and implementing the change at the bedside. The nurses will be responsible for collecting the data. A creation of
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