5. Highest level of newborn care available at your facility? *This question is required.

• Newborn nursery-Level 1
• SCN Level 2
• NICU Level 3
• NICU Level 4

6. What leadership team oversees the staff in the SCN/NICU? *This question is required.

• Postpartum Leadership
• SCN/NICU leadership
• All of women’s services under one leadership team
• Other

7. Is there a nurse driven standardized algorithm to guide clinical management of asymptomatic newborns at-risk for hypoglycemia at your facility? *This question is required.

• Yes
• No

Current approach to management of the asymptomatic at-risk hypoglycemic newborn aligns with?

• AAP guidelines
• Pediatric Endocrine Society guidelines
• Locally derived management protocol

8. Is there an IV weaning protocol in your unit for infants who receive continuous IV therapy solely for the treatment of hypoglycemia? 
 

• Yes
• No
• N/A

9. Do you currently use glucose gel as a treatment method for the asymptomatic newborns with hypoglycemia? *This question is required.

• Yes
• No

10. What risk factors do you use to identify newborns at-risk for hypoglycemia? (select all that apply)
  *This question is required.

• SGA
• LGA
• IDM
• LPT (35-36 6/7)
• Maternal history of Beta Blockers
• N/A no current criteria identified-Provider determined
• Other

11. Do all providers use the same glucose level to define a newborn as hypoglycemic? *This question is required.

• Yes
• No

What glucose level is used to define hypoglycemia? *This question is required.

• < than or equal to 25
• < than or equal to 30
• < than or equal to 35
• < than or equal to 40
• < than or equal to 50
• < than or equal to 55
• < than or equal to 60
• Other

12. Is it common practice to confirm low glucose levels obtained at the bedside, which has deemed a newborn hypoglycemic, by sending an additional specimen to the lab prior to starting IV infusion treatment or prior to transfer to higher level of care?  *This question is required.

• Yes
• No

13. Is separation of the infant from mother, within the first 2 hours of life, required to assess, screen or treat the asymptomatic newborn for hypoglycemia? *This question is required.

• Yes
• No

14. If infant requires IV therapy for hypoglycemia, does the infant require transfer to a higher level of care? *This question is required.

• Yes, within my facility
• Yes, outside of my facility
• No, IV infusions occur in the newborn nursery/PP floor

15. Does your unit promote skin to skin immediately following delivery? *This question is required.

• Yes
• No

16. Are hypoglycemia order sets integrated in the EMR? 

• Yes
• No

17. Is your team currently providing educational resources regarding hypoglycemia (check all that apply)? *This question is required.

• Yes, internally created resource
• Yes, externally created resource
• Yes, PQCNC created resource
• No

18. Is there documentation in the EMR/chart that the parent or family was educated regarding hypoglycemia? *This question is required.

• Yes
• No

19. Has your facility completed the Baby Friendly Certification? *This question is required.

• Yes
• In process
• No