Innovations and Challenges of Implementing a Glucose Gel Toolkit for Neonatal Hypoglycemia.

BACKGROUND: Transient neonatal hypoglycemia occurs most commonly in newborns who are small for gestational age, large for gestational age, infants of diabetic mothers, and late preterm infants. An exact blood glucose value has not been determined for neonatal hypoglycemia, and it is important to note that poor neurologic outcomes can occur if hypoglycemia is left untreated. Interventions that separate mothers and newborns, as well as use of formula to treat hypoglycemia, have the potential to disrupt exclusive breastfeeding. PURPOSE: To determine whether implementation of a toolkit designed to support staff in the adaptation of the practice change for management of newborns at risk for hypoglycemia, that includes 40% glucose gel in an obstetric unit with a level 2 nursery will decrease admissions to the Intermediate Care Nursery, and increase exclusive breastfeeding. METHOD: This descriptive study used a retrospective chart review for pre/postimplementation of the Management of Newborns at Risk for Hypoglycemia Toolkit (Toolkit) using a convenience sample of at-risk newborns in the first 2 days of life to evaluate the proposed outcomes. RESULTS: Following implementation of the Toolkit, at-risk newborns had a clinically but not statistically significant 6.5% increase in exclusive breastfeeding and a clinically but not statistically significant 5% decrease in admissions to the Intermediate Care Nursery. IMPLICATIONS FOR PRACTICE: The Toolkit was designed for ease of staff use and to improve outcomes for the at-risk newborn. IMPLICATIONS FOR RESEARCH: Future research includes replication at other level 2 and level 1 obstetric centers and investigation into the number of 40% glucose gel doses that can safely be administered.

Influencing nutritional habits of college students using a food pantry.

Objective: Food insecurity in college students is associated with poor eating habits. The purpose of this project was to increase consumption of fruits and vegetables in college students using a campus food pantry. Participants: Twenty-nine college students completed the study. Methods: Participants viewed weekly food preparation videos demonstrating cost-effective recipes containing fruits and vegetables and a key take-away message. Participants were provided a recipe and food to cook at home based on the Cooking Matters Food Pantry Toolkit. A 24-h dietary recall was collected pre- and postintervention using the Automated Self-Administered 24-H Dietary Assessment. This descriptive comparative study used repeated measure ANOVA. Results: Females (n = 19) increased their fruit and vegetable consumption by 1.3 cups daily (p < .05) while males (n = 10) decreased fruit and vegetable consumption at the postintervention measurement. Conclusion: Increased consumption of fruits and vegetables in female college students using the food pantry was a modifiable behavior in this study.

Adapting Pediatric Clinical Experiences to a Changing Health Care Environment.

Consolidation and regionalization in pediatric acute care hospitals have limited clinical opportunities for prelicensure nursing students. The use of schools as primary learning sites offers an opportunity for a combined pediatric and public health clinical experience for nursing students. The purpose of the study was to compare pediatric knowledge and clinical simulation performance between hospital- and community-based pediatric clinical experiences. Study results indicated no difference between groups based on knowledge or simulation scores.

The Postcard Initiative: Personal Communication From Students Can Increase Timely Compliance With Health Requirements.

BACKGROUND: Immunizations and physical exams ensure the health and safety of school children. Failure to comply with state regulations can lead to exclusion from school activities. METHODS: Students in fifth and eighth grades personalized postcards that contained health requirements for entry into sixth (junior high) and ninth (high school). The postcards were mailed three times over the school year. The junior high had a decline in first-day exclusions that did not reach significance. The high school decreased first-day exclusions from 6.4% to 1.6%. Both schools had significantly more physicals turned in before August 1 when compared with the previous year. CONCLUSION: Communicating health requirements by personalized postcards provides information in a manner that is better understood by parents/guardians.

Reinventing the home visit for undergraduate nursing students.

The Family Outreach Project was designed to teach senior-level undergraduate nursing students how to assess, care for, and develop care plans for children with chronic health conditions and their families. Nursing students (n=24) could attend one focus group conducted at the end of the semester as part of the evaluation of the America's Promise School Project. Responses were audiotaped and transcribed verbatim. Qualitative methods were used to identify themes. Comfort with the visit, professionalism of the students, and usefulness of the home visit to families was assessed. Analysis of focus group responses identified four major themes: learning experience, observations about home environment, concerns about having nothing to offer families, and difficulties with arranging and carrying out the home visits. Family responses (n=10) supported students' perception that families were knowledgeable about their children's chronic health conditions. Families indicated that students were professional and treated families respectfully.