Infant Blood Workaround Case Study

Infant Blood Glucose Monitoring: Staff Workaround
Policy and procedure play a huge part in the nursing career. They provide the health care team with written directions on how do something the way the hospital wants the employee to do it. Are the hospitals policies and procedures always current on best practice? No. This is why it is important as future nurses to start to research and make sure that the institution is keeping current with the latest best practice changes.
Current Policy and Procedure
For my capstone clinical, I was at St. Vincent’s Postpartum Unit. Here, I learned many valuable skills while taking care of mom and baby. The policy that I used the most during my clinical would be the Infant Blood Glucose Monitoring Policy and

Adamkin uses a chart to describe the screening used for infants who are at risk for developing hypoglycemia (appendix B) (Adamkin, 2011). The policy adapts this chart and puts it into written form (appendix A, p. 2). The article also states that late preterm infants and small for gestational age infants are screened through 24 hours (Adamkin, 2011). Infants of diabetic mothers, large for gestational age babies should be screened for 12 hours (Adamkin, 2011). The only difference between this and the policy is that the policy states that intrauterine growth restricted infants should also be screened for 12 hours. It seems that almost everything from the policy is taking right from the Pediatrics

One week, my nurse and I had a patient who was delivering at 36 weeks. Because of this, she knew that the baby had to have blood glucose screening done. Instead of just trying to remember what the policy stated, my nurse went onto the Intranet and printed of the policy for Infant Blood Glucose Monitoring. She then clipped the policy to the infants chart so that, if the mom didn’t deliver, it would be there for the next nurse. Later on in our shift, the mom did deliver. The problem was that the mom only wanted to pump and feed the child. The infant ended up not getting his first feeding until after the one-hour mark (and the all the mother pumped looked like condensation). In the policy, it states that if no breast milk could be expressed to call health care provider for orders for minimal amount of breast milk substitute to be supplemented. Because of this, my nurse had to get the blood sugar as soon as she could because we were past the one-hour point. When we took the blood glucose, it was less than 25. Due to this, we had to send a blood sample down to lab stat. Because the mom did not want to breast feed, we gave the infant 15 mL of formula. The next time we took at blood glucose, it was up to 40, so no farther action was