28 - Performance of a Web-Based Newborn Hypoglycemia Management Tool

Publication Number: 2025.28

Walid Maalouli, University of Minnesota Masonic Children's Hospital, Minneapolis, MN, United States; Laura Hagemeyer, University of Minnesota Masonic Children's Hospital, Brooklyn Park, MN, United States; Gertrude Wilson, MHEALTH MASONIC CHILDREN'S HOSPITAL, Minneapolis, MN, United States

Background: The use of paper-based algorithms for the management of neonatal hypoglycemia can be error-prone and could lead to erroneous interventions and potentially patient harm. The lack of bedside access also introduce delays in decision-making which could aggravate the hypoglycemic state.

Objective: Introduce a web-based decision support neonatal hypoglycemia management tool to:
1- reduce the time interval between hypoglycemia detection and active intervention without an concomitant increase in Neonatal Intensive Care Unit (NICU) transfers for hypoglycemia
2- improve nursing satisfaction with the neonatal hypoglycemia management process

Design/Methods: A web-based neonatal hypoglycemia decision support tool was developed (https://pedsmedcalc.net/hypoglycemia/main.html) based on the equivalent paper-based management algorithm for our institution (a tertiary medical center) and a link was installed on all the computers in the post-partum unit including the patient rooms. All the nurses in the unit were trained on its use and subsequently instructed to exclusively use the decision support tool. All newborns with a gestational age >= 35 weeks and at least 1 episode of hypoglycemia were included. A 3-month baseline data was collected prior to the start of the project including time interval from oral glucose gel (OGG) order to administration, percent of NICU transfers for hypoglycemia, and nursing satisfaction via a questionnaire (Figure 1), followed by 1 intervention interval and 2 additional intervention intervals of 3 months each with similar data collected at the end of each interval. The p-value of the linear regression slope for each outcome was calculated using the Microsoft Excel Data Analysis Tool.

Results: The study ran from January 2024 to November 2024 and included a total of 218 newborns >= 35 weeks gestation with hypoglycemia, consisting of 70 (32.1%) at baseline, 52 (23.9%) at intervention, 78 (35.8%) at maintenance 1 and 18 (8.4%) at maintenance 2 (Table 1). Nursing satisfaction with the decision support tool improved significantly (p = 0.012), while the OGG interval from order to administration and NICU transfers also significantly declined (p = 0.021 and p = 0.018 respectively).

Conclusion(s): A web-based decision support tool for neonatal hypoglycemia management appears to be effective in reducing delays in interventions and significantly improving nursing satisfaction without an increase in NICU transfers, primarily by providing easy bedside accessibility and a directed computerized management algorithm.

Neonatal Hypoglycemia Decision Support Tool Outcomes
Table 1.pdfNeonatal Hypoglycemia Decision Support Tool Outcomes

Nursing questionnaire
Figure 1.pdfNursing questionnaire

Neonatal Hypoglycemia Decision Support Tool Outcomes
Figure 2.pdfNeonatal Hypoglycemia Decision Support Tool Outcomes