New blood glucose analysers make a significant difference

BEV POWNALL 

Team Leader, Lactation Support Services

The introduction, at the end of 2019, of two new blood glucose analyser machines for use in the maternity ward and birthing and assessment unit has made a significant difference to the comfort of babies, mothers and their whaanau.

The two machines, designed for use on neonates, were purchased and installed following a trial in September 2019.

The trial itself arose from staff concerns over the appropriateness of products designed for testing blood glucose in adults, which at the time were also being used on newborn babies, despite there being no evidence to support their use. Staff noted that the product was returning frequent false negative and positive results, and often required repeated heel-stick blood tests, leading to delays in transfers form the birthing and assessment unit to the wards and in the discharge process. The trial investigated how blood glucose testing might be improved. Specific aims included:

• improving accuracy in test results

• reducing multiple avoidable blood tests for newborn at-risk babies • improving staff satisfaction and workflow • reducing unnecessary use of infant formula.

The Lactation Support Services team based at Middlemore Hospital assisted with the trial, with 10 staff trained to take samples and act as champions. The results suggested that by using trained staff who are skilled in capillary sampling, providing training in the correct use of the blood glucose analyser, and enabling samples to be processed on the ward in a timely manner the first three specific aims could be met (no impact was noted on the use of infant formula).

The decision (taken near the end of the trial in 2019) to purchase two blood glucose analysers suitable for use with neonates has been welcomed by staff. Acknowledgement is due to those staff who identified issues with the previous approach and advocated for fit-for-purpose equipment to be made available for mothers and newborns.

The analysers became fully operational during 2020. Anecdotal benefits noted to date include a significant reduction in hold-ups for mothers and babies waiting to be transferred or discharged, and the avoidance of repeated heel sticks for most babies. Other anticipated benefits include reduced family stress and dissatisfaction, reduced staff frustration and stress, savings in time and money, and avoidance of potential for loss of confidence in breastfeeding by mothers.

The Lactation Support Services team will continue to investigate ways to support, promote and protect breastfeeding.