6283 Hypoglycaemia screening in neonates investigations tool

Objectives To enable neonatal team to perform a hypoglycaemia screen quicker in qualifying babies admitted to the Neonatal unit, utilising visual aids in the treatment room and the creation of a grouped order list in the local Information Technology (IT) system. Methods Feedback from colleagues during a review of babies admitted to our Neonatal Unit and investigated for persistently low blood sugars, indicated difficulties and delays in performing these investigations – therefore potentially delaying hypoglycaemia treatment – especially out of hours when staffing levels are low and there is limited senior presence. Investigating persistent hypoglycaemia in a neonate involved locating and consulting the local guidelines on trust intranet, identifying individual tests on IT system and collecting necessary sample bottles with appropriate labels before administering emergency treatment for hypoglycaemia.1 We recognised that this is a time-consuming process for staff who are not necessarily familiar with the local guidelines and IT system, where individual investigations exist but are not grouped together. A meeting was set up between the Neonatal team and the local digital transformation board about creating a tool to overcome this challenge. It was agreed that all necessary investigation requests would be pooled together to create an order list under the title 'Hypoglycaemia Screen Neonates. When the investigator types 'hypo' in the lab orders, the list will show up together with information on the various samples needed. We recognised that this could save time and lead to a more consistent investigation of hypoglycaemia. The order set also assists investigators by providing prompts/warnings for iced samples, length of time from sampling to lab and advice on tests that need completing as point of care testing at the same time. We have printed and laminated the necessary investigations to be stuck on the walls of the treatment room in our Neonatal unit (as a visual aid for the investigator to help assemble their equipment quickly). Pre-made investigation packs were not favoured by the team because of the risk of sample bottles being removed, lost or not kept up to date Results The hypoglycaemia screen order set is now live on the IT system along with the physical visual aids. This was also shared with our Paediatric ward and we have increased awareness by sharing with all during handover meetings. The feedback has been positive so far with regards to being easy to use as well as educational, especially for non- career paediatricians that work on our Tier1 rota. This has made the investigation process less time consuming and more effective in terms of completion and patient safety.1Figures 1 and 2. Conclusion In a Quality improvement project, we created an order set in the local IT system for babies with persistent hypoglycaemia to make the process quicker and enable more consistent investigations. Preliminary feedback – to be confirmed in serial audits over the next 18 months – suggests that those colleagues working out-of-hours and who are non-career paediatricians are finding this to be of most benefit. Reference BAPM: Identification and management of neonatal hypoglycaemia in the full term Infant, April 2017