Most Proposed Topic :
Healthcare Advances, Research and Innovations (new projects / technology)
Authors: (including presenting author): :
Chu L.Y.(1), So H.Y.(1), Chau O.K.(1), & Leung M.K(1)
Affiliation: :
(1)Department of Paediatrics and Adolescent Medicine, Kwong Wah Hospital
Introduction: :
Hypoglycemia is a common problem encountered in preterm and sick neonates requiring medical interventions, in neonatal unit, intravenous dextrose is currently the standard treatment when babies experience hypoglycemic episodes. However, peripheral intravenous access can sometimes be difficult to establish in neonates and is an invasive procedure. The procedure also carries risks of infection, complications from prolonged vessel irritation, and is distressing for both babies and their parents.
Untreated hypoglycemia has been associated with adverse short and long-term neurodevelopmental outcomes in neonates. While intravenous dextrose remains the treatment of choice in more severe cases, mild to moderate hypoglycemia can be safely managed with alternate oral therapy. Glucogel is a concentrated glucose （40% Dextrose monohydrate) gel formulation that has been used successfully to treat hypoglycemia orally. Its use avoids the need for invasive intravenous lines when clinical stability permits, and oral feeding is sufficient.
Objectives: :
This quality improvement project aimed to develop and implement an educational program to allow safe and effective use of oral glucogel for treating hypoglycemia in the SCBU, avoiding intravenous lines when appropriate.
Methodology: :
An educational package was developed including a standardized comprehensive glucogel administration workflow, instructional leaflet for parents, and training video for nurses. Total 65 staff were required to attend an in-person teaching session reviewing indications, contraindications, and appropriate administration techniques for glucogel based on the developed materials. Nurses then completed a return demonstration of glucogel administration that was checked off by the trainer.
Result & Outcome: :
All neonate nurses completed the educational program. The revised hypoglycemia protocol and glucogel treatment workflow have been adopted since 19th April 2022. Since implementation on April 19, 2022 until December 31, 2023, 37 neonates were successfully treated for hypoglycemia with glucogel, avoiding the need for intravenous dextrose. All nursing staff members demonstrated 100% compliance during competency return demonstrations and proper administration technique.
The educational program was effective in training neonatal nurses on appropriate use of glucogel for managing neonatal hypoglycemia. Early results support that glucogel provides a safer, less invasive first-line treatment option when clinically appropriate. Continued auditing will monitor ongoing compliance and assess any need for additional training. Overall, this quality improvement aims to establish best practice through optimized, evidence-based care of at-risk newborns in neonatal units.
