ArticlePediatrics2018
A Quality-Improvement Initiative to Reduce NICU Transfers for Neonates at Risk for Hypoglycemia.
Article in Pediatrics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 36 citations in OpenAlex.
- [Management of hyperglycemia in pregnancy (Update 2026)].Wiener klinische Wochenschrift · 2026Review
- Improving timing of early neonatal hypoglycemia screening in the well-baby nursery.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Oral dextrose gel for hypoglycemia in a well-baby nursery: a baby-friendly initiative.Journal of perinatology : official journal of the California Perinatal Association · 2025Article
- "I Am Going to Take It Up": Implementing Skin-to-Skin Contact in Uganda.Maternal & child nutrition · 2025Article
- Beyond Pain Management: Skin-to-Skin Contact as a Humanization Strategy in Cesarean Delivery: A Randomized Controlled Trial.Healthcare (Basel, Switzerland) · 2025Article
- A quality improvement initiative for neonatal hypoglycemia screening and management in a level III neonatal intensive care unit.Journal of perinatology : official journal of the California Perinatal Association · 2023Article
- Fewer glucose checks and decreased supplementation using dextrose gel for asymptomatic neonatal hypoglycemia.Journal of perinatology : official journal of the California Perinatal Association · 2023Article
- A feed-centric hypoglycaemia pathway ensures appropriate care escalation in at-risk infants.BMJ open quality · 2021Article
- Early essential newborn care is associated with improved newborn outcomes following caesarean section births in a tertiary hospital in Da Nang, Vietnam: a pre/post-intervention study.BMJ open quality · 2021Article
- Strategies to improve neurodevelopmental outcomes in babies at risk of neonatal hypoglycaemia.The Lancet. Child & adolescent health · 2021Review
- Evaluating the effects of a neonatal hypoglycemia bundle on NICU admission and exclusive breastfeeding.Journal of perinatology : official journal of the California Perinatal Association · 2020Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
BACKGROUND AND
objectiveNeonatal hypoglycemia is a common problem, often requiring management in the NICU. Nonpharmacologic interventions, including early breastfeeding and skin-to-skin care (SSC), may prevent hypoglycemia and the need to escalate care. Our objective was to maintain mother-infant dyads in the mother-infant unit by decreasing hypoglycemia resulting in NICU transfer.
methodsInborn infants ≥35 weeks' gestation with at least 1 risk factor for hypoglycemia were included. Using quality-improvement methodology, a bundle for at-risk infants was implemented, which included a protocol change focusing on early SSC, early feeding, and obtaining a blood glucose measurement in asymptomatic infants at 90 minutes. The primary outcome was the overall transfer rate of at-risk infants to the NICU. Secondary outcomes were related to protocol adherence. Balancing measures, including the rate of symptomatic hypoglycemia and sepsis evaluations, were monitored. Statistical process control charts using standard interpretation rules were used to monitor for improvement in key aims.
resultsFor infants at risk for hypoglycemia, the NICU transfer rate decreased from 17% to 3% overall. Documented early feeding and SSC in at-risk newborns increased. The percent of at-risk infants transferred to the NICU who did not require intravenous dextrose decreased from 5% at baseline to 0.7% after intervention. There were no adverse outcomes observed in the period before or after the intervention.
conclusionsThe implementation of a quality-improvement intervention promoting SSC and early feeding in at-risk infants was associated with a decreased rate of transfer to the NICU for hypoglycemia.
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Registered trials
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