6752 Neonatal hypoglycaemia risk assessment, detection and management on the post-natal ward: an audit

Objectives Hypoglycaemia is a cause of morbidity and mortality in neonatal populations. Identification of at-risk groups and timely management is key to improving outcomes. Our local guideline categorises infants as Red, Amber or Green depending on different risk factors. 'Red' infants should automatically receive pre-feed blood glucose monitoring, and treatment for hypoglycaemia differs between categories: Methods We used Badgernet to identify infants born on site between 27 July – 27 September 2023. All blood gas results were collected from the post-natal ward (PNW) machine for the study period. Data was collected from the following sources: 1) Badgernet lists (Mothers with diabetes, hypertension or pre-eclampsia; babies under observation) and 2) Electronic patient records (oral glucose gel prescription and administration). Finally, full review of badger notes for risk factors was undertaken for all infants with hypoglycaemia and 50 infants selected through random number generation. Results 672 infants were born over the 2-month period. Table 1 shows the frequency of infants with hypoglycaemia stratified by risk category. 62.8% 'Red' infants had 3 or more blood gases taken, the first of which was on average 6 hours 53 minutes from birth. 35% of hypoglycaemic episodes in 'Red' babies were treated, and on average, across all categories, there were 22.5 and 34.5 minutes from measured hypoglycaemia to prescription and administration of treatment, respectively. 85.3% of infants sampled were correctly categorised. Conclusion Our results demonstrate poor local compliance with infant risk assessment, hypoglycaemia monitoring and treatment. Furthermore, we are not meeting latest BAPM1 guidance for first blood glucose measurement: 2–4 hours after birth. A limitation is our inclusion of only PNW blood gas data, which may miss a minority of initial blood gases undertaken on Labour Ward or data for infants not on PNW. Improvement is planned through departmental training and use of recently adopted electronic record system. Reference Identification and Management of Neonatal Hypoglycaemia in the Full Term Infant (Birth – 72 hours). A BAPM DRAFT framework for practice, British Association of Perinatal Medicine 2023.