Delaying the First Bath Decreases the Incidence of Neonatal Hypoglycemia

Abstract

Poster Presentation Objective To explore rates of neonatal hypoglycemia as an outcome after implementation of a newborn care procedure to delay the bath until at least 12 hours of life. Design A retrospective chart review. Setting A mother/baby unit, with 1150 births per year, in an urban community hospital. Sample The total sample included data on 1135 newborns; the preintervention sample A included data on 578 births and the postintervention sample B included data on 557 births. Methods Blood glucose results were obtained from the electronic medical record. The reason for the blood glucose measurement was cross referenced against the risk factors for neonatal hypoglycemia. Results A blood glucose level of 49 or less was considered hypoglycemic in this study. Newborns in Sample A (no delayed bath) had an 8.5% incidence of hypoglycemia on the initial blood glucose measurement. In Sample B (delayed bath), the hypoglycemia rate was 3.5%. Newborns at high risk for hypoglycemia, including large for gestational age, small for gestational age, and maternal gestational diabetes are required to have a blood glucose measurement. Sample A (no delayed bath) had 176 high‐risk infants and Sample B (delayed bath) had 142 high‐risk infants. The high risk infants in Sample A had a 27.8% rate of hypoglycemia on initial blood glucose measurement. The high risk infants in Sample B had a 14% rate of hypoglycemia on the initial tests. Conclusion/Implications for Nursing Practice This study shows that delaying the initial bath for the newborn may decrease rates of hypoglycemia by 50% in high‐risk infants and can result in a similar reduction in hypoglycemia for low‐risk infants. The prior practice was to give the infant a bath of 98 degrees Fahrenheit within 2 hours of life. The 12‐hour guideline eliminates the concern that nurses may leave tasks unfinished at the end of their shift. The results promote nursing practice that prioritizes safe outcomes for patients over task completion.