Newborn Glucose Management-Clinical Decision Support Systems

Purpose:
Utilizing standard clinical decision support tools in the Electronic Medical Record, the purpose was to automate Newborn Glucose Protocols based on newborn hypoglycemia risk factors to assure appropriate glucose management and reduce the reliance on nursing memory.

Significance:
"Well baby" triggers the image of a newborn without medical needs, however ongoing assessment by health care providers assures appropriate adaptation to extrauterine lifed. One area that can be impaired is glucose control. Identification of hypoglycemia risk factors in 1/4 of newborn assessments.

Strategy and Implementation:
After approval of a hypoglycemia protocol and the automation of such protocol by medical staff committees, an automated clinical decision support system was built into the Electronic Medical Record using standard decision support tools and rules. The result was automation of the hypoglycemia order entry into the newborn chart via documentation of risk factors by nursing. The inclusion of the standard hypoglycemia risk factors into the routine newborn initial assessment documentation of the electronic medical record provided the standardization and compliance for use of this decision support system.

Evaluation:
Prior to implementation of the clinical decision support system, nursing decisions were flawed 21 percent of the time when evaluating newborn hypoglycemia risk factors and implementing the appropriate protocol. Post implementation, flawed decisions were reduced to less than 5%.

Implications for Practice:
Utilization of clinical decision support systems for nursing to automate practice of protocols based upon routine documentation can dramatically improve patient outcomes.