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and articles were restricted to English language published within the last 7 years. The authors state that dextrose gel has the potential to increase breastfeeding rates, decrease NICU admissions, reduce mother baby separation, and improve patient satisfaction (Newnam & Bunch,2017, p. 476). The article concludes that additional randomized control trials are needed to showlong-term effects, however there is enough evidence to warrant the use of dextrose gel in hypoglycemia protocols and clinical policies should be revised to include the use of dextrose gel (Newnam & Bunch, 2017, p. 476). The information from this article supports the practice change recommendation by providing the evidence-based research to show that the use of glucose gel is safe, effective at increasing blood glucose levels, and helps maintain exclusive breastfeeding.Evidence-Based Practice RecommendationBased on the information gathered from the evidence summary, the practice recommendation will be a restructured version of the current newborn hypoglycemia protocol in an effort to increase the rate of exclusive breastfeeding and prevent the mother/baby couplet from being separated due to a NICU transfer related to hypoglycemia. This best practice will continue to incorporate our current guidelines for BSG levels, as well as encouraging skin-to-skin (STS) as much as possible. For mothers that would like to exclusively breastfeed, this practice recommendation to use weight based doses of glucose gel instead of formula, will
GLUCOSE GEL AS A PRIMARY TREATMENT9support their desire avoid formula. In the study conducted by Alsweiler, Woodall, Crowther, and Harding (2018), evidence showed that glucose gel was just as effective as formula in treatinghypoglycemia in the newborn. It is recommended to stop using formula to help increase the BSG levels in the newborns, even the newborn at risk for hypoglycemia. Practice Change ModelThe ACE Star Model of Knowledge Transformation is a systematic approach for implementing evidence-based research into nursing practice to improve the quality of patient care. According to Schaffer, Sandau, & Diedrick (2013), the ACE Star Model is comprised of these five model steps: (1) discovery; (2) evidence summary; (3) practice recommendations; (4) integration into clinical practice; and (5) evaluation of the process and outcomes (p. 1200). The focus of this model is the application of evidence-based research being implemented in the clinical setting and the factors that influence the likelihood that practice change will become the standard of care. Schaffer, Sandau, & Diedrick (2013) point out that the ACE Star Model is readily understood by nurses as it has similarities to the nursing process (p.1200). This model of knowledge synthesizes information by improving on old concepts with evidence-based research to provide a framework for new processes and protocols.