First name
Lauren
Last name
Skerritt

Title

Improving Compliance With Revised Newborn Hepatitis B Vaccination Policy.

Year of Publication

2021

Date Published

2021 Dec 01

ISSN Number

2154-1671

Abstract

<p><strong>BACKGROUND: </strong>In September 2017, the American Academy of Pediatrics issued guidance recommending hepatitis B vaccine be administered to well newborns with birth weight ≥2000 g within 24 hours after birth. At that time, ∼85% of well newborns were vaccinated before discharge at our center; however, only 35% were vaccinated within 24 hours after birth. Our aim was to vaccinate 70% of eligible newborns within 24 hours after birth by June 2018 while maintaining the overall rate of vaccination.</p>

<p><strong>METHODS: </strong>A multidisciplinary improvement team analyzed existing vaccine administration processes in the well-newborn nursery. From October 2017 to January 2018, changes were made to activation of vaccine orders and to obtaining and documenting the consent processes. Vaccine administration was bundled with routine care given ≤24 hours after birth, and parent scripting was changed from offering vaccine as an option to stating it as a recommendation. From November 2016 to June 2019, we determined the overall rate and timing of vaccination using statistical process control methods.</p>

<p><strong>RESULTS: </strong>Among 10 887 eligible infants, the proportion administered hepatitis B vaccine ≤24 hours after birth increased from 35.5% to 78.8% after process changes with special-cause variation on process control charts. Proportion of infants receiving vaccine any time before discharge also increased from 86.5% to 92.3%.</p>

<p><strong>CONCLUSIONS: </strong>Specific process changes allowed our birth center to comply with the recommended timing for hepatitis B vaccination of ≤24 hours after birth among eligible newborns.</p>

DOI

10.1542/hpeds.2021-005969

Alternate Title

Hosp Pediatr

PMID

34808667

Title

Clinical impact of neonatal hypoglycemia screening in the well-baby care.

Year of Publication

2020

Date Published

2020 Mar 09

ISSN Number

1476-5543

Abstract

<p><strong>OBJECTIVES: </strong>To determine the proportion of well-appearing newborns screened for hypoglycemia, yield of specific screening criteria, and impact of screening on breastfeeding.</p>

<p><strong>STUDY DESIGN: </strong>The retrospective study of well-appearing at-risk infants born ≥36 weeks' gestation with blood glucose (BG) measurements obtained ≤72 h of age.</p>

<p><strong>RESULTS: </strong>Of 10,533 eligible well newborns, 48.7% were screened for hypoglycemia. Among tested infants, BG &lt; 50 mg/dL occurred in 43% and 4.6% required intensive care for hypoglycemia. BG &lt; 50 mg/dL was associated with lower rates of exclusive breastfeeding (22% vs 65%, p &lt; 0.001). Infants screened due to late-preterm birth were most frequently identified as hypoglycemic. The fewest abnormal values occurred among appropriate weight, late-term infants of nondiabetic mothers.</p>

<p><strong>CONCLUSION: </strong>Hypoglycemia risk criteria result in screening a large proportion of otherwise well newborns and negatively impact rates of exclusive breastfeeding. The risks and benefits of hypoglycemia screening recommendations should be urgently addressed.</p>

DOI

10.1038/s41372-020-0641-1

Alternate Title

J Perinatol

PMID

32152490

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