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Randomized Controlled Trial
. 2017 Nov 22;7(11):e017516.
doi: 10.1136/bmjopen-2017-017516.

Midwife or doctor local opinion leader to implement a national guideline in babies on postnatal wards (DesIGN): protocol of a cluster-randomised, blinded, controlled trial

Jane Marie Alsweiler  1 , Caroline A Crowther  2 , Jane E Harding  2
Affiliations
Randomized Controlled Trial

Midwife or doctor local opinion leader to implement a national guideline in babies on postnatal wards (DesIGN): protocol of a cluster-randomised, blinded, controlled trial

Jane Marie Alsweiler et al. BMJ Open. .

Abstract

Introduction: Neonatal hypoglycaemia is a common condition that can cause developmental delay. Treatment of neonatal hypoglycaemia with oral dextrose gel has been shown to reverse hypoglycaemia and reduce admissions to neonatal intensive care for hypoglycaemia. An evidence-based clinical practice guideline was written to guide the use of dextrose gel to treat neonatal hypoglycaemia in New Zealand. However, it is unclear what clinical discipline might most effectively lead the implementation of the guideline recommendations.

Objective: To determine if midwife or doctor local opinion leaders are more effective in implementing a clinical practice guideline for use of oral dextrose gel to treat hypoglycaemia in babies on postnatal wards.

Methods and analysis: A cluster-randomised, blinded, controlled trial. New Zealand maternity hospitals that care for babies born at risk of neonatal hypoglycaemia will be randomised to having either a local midwife or doctor lead the guideline implementation at that hospital. The primary outcome will be the change in the proportion of hypoglycaemic babies treated with dextrose gel from before implementation of the guideline to 3 months after implementation.

Ethics and dissemination: Approved by Health and Disability Ethics Committee: 15/NTA/31. Findings will be disseminated to peer-reviewed journals, guideline developers and the public.

Trial registration number: ISRCTN61154098.

Keywords: clinical practice guideline; hypoglycaemia; implementation; neonate; oral dextrose gel.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Strategy to determine local opinion leader.
See this image and copyright information in PMC

References

    1. Maayan-Metzger A, Lubin D, Kuint J. Hypoglycemia rates in the first days of life among term infants born to diabetic mothers. Neonatology 2009;96:80–5. 10.1159/000203337 - DOI - PubMed
    1. Lucas A, Morley R, Cole TJ. Adverse neurodevelopmental outcome of moderate neonatal hypoglycaemia. BMJ 1988;297:1304–8. 10.1136/bmj.297.6659.1304 - DOI - PMC - PubMed
    1. McKinlay CJD, Alsweiler JM, Anstice NS, et al. . Association of neonatal glycemia with neurodevelopmental outcomes at 4.5 Years. JAMA Pediatr 2017;171:972 10.1001/jamapediatrics.2017.1579 - DOI - PMC - PubMed
    1. Kaiser JR, Bai S, Gibson N, et al. . Association between transient newborn hypoglycemia and fourth-grade achievement test proficiency: a population-based study. JAMA Pediatr 2015;169:913–21. 10.1001/jamapediatrics.2015.1631 - DOI - PubMed
    1. Harris DL, Weston PJ, Signal M, et al. . Dextrose gel for neonatal hypoglycaemia (the Sugar Babies Study): a randomised, double-blind, placebo-controlled trial. Lancet 2013;382:2077–83. 10.1016/S0140-6736(13)61645-1 - DOI - PubMed

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