The 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.Ĭopyright © 2018 by the American Academy of Pediatrics. There were no adverse outcomes observed in the period before or after the intervention. 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. Documented early feeding and SSC in at-risk newborns increased. Statistical process control charts using standard interpretation rules were used to monitor for improvement in key aims.įor infants at risk for hypoglycemia, the NICU transfer rate decreased from 17% to 3% overall. Balancing measures, including the rate of symptomatic hypoglycemia and sepsis evaluations, were monitored. Secondary outcomes were related to protocol adherence. The primary outcome was the overall transfer rate of at-risk infants to the NICU. 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.
Inborn infants ≥35 weeks' gestation with at least 1 risk factor for hypoglycemia were included. Our objective was to maintain mother-infant dyads in the mother-infant unit by decreasing hypoglycemia resulting in NICU transfer. Nonpharmacologic interventions, including early breastfeeding and skin-to-skin care (SSC), may prevent hypoglycemia and the need to escalate care.
If you can, please use our experience to your advantage.Neonatal hypoglycemia is a common problem, often requiring management in the NICU. We often have vivid memories of what it was like where you are now. If you need care not covered by insurance, ask about our deep self-pay discount.Īt ShoreFUN, we are all mothers. ShoreFUN Pediatrics accepts all insurances, including NC but not SC Medicaid. Contact us to schedule an appointment today. We take the medical home concept seriously, and want to help you avoid hospital visits if possible. Her pediatric residency training was completed at the Medical College of Virginia in 1993, followed by 3 years of fellowship training in Developmental Pediatrics at the Children’s Hospital of Philadelphia and Children’s Seashore House in 1996. During the day, advice calls come to our triage nurse, who can quickly get you where you need to be. We have an active patient portal where you can view your child’s records-we hope to have interactive email soon! And you can find us on Facebook, so we can communicate with you about vaccines, new developments, general scheduling info, weather delays, etc.Īfter hours, you can call the office line where you will be directed to a trained nurse triage line they have our specific information on common problems you might have, and one of us is on call as backup 24/7/365. We will electronically prescribe, for safety, accuracy and quick delivery at your pharmacy. We believe in the accuracy and clarity of computerized records, but will not let the computer get in the way of our interaction with you. A specialty visit can mean a trip to Wilmington, Chapel Hill, Durham or Charlotte, but primary and follow-up care will be AT HOME-and convenient. We will refer your child directly when needed, communicating with our colleagues in writing and by phone, to COORDINATE care and share records rather than duplicating effort and testing. We believe that hospital care needs to be in a PEDIATRIC unit, with 24/7 pediatric physicians on site, pediatric specialty care, university affiliation, and child and infant intensive care. We believe that office should be in your community, not an hour away.
That way, you and your child have access to all of us at the time that suits you best. We believe in one office, open as many hours as possible, with walk-in hours all day long. We believe health care is never “one size fits all” and much better delivered by an independent physician whose first and only priority is your child’s health-not a corporation or health care system where interests conflict and success is measured in corporate profit. We are dedicated to providing you with the best, most up to date, convenient, specialized care. We are honored that you have chosen to trust us with your child’s health and your peace of mind.