Jaspreet Loyal1, James A Taylor2, Carrie A Phillipi3, Neera K Goyal4, Niramol Dhepyasuwan5, Eugene D Shapiro6, Eve Colson6. 1. Department of Pediatrics, Yale University, New Haven, Conn. Electronic address: Jaspreet.Loyal@yale.edu. 2. Department of Pediatrics, University of Washington, Seattle. 3. Department of Pediatrics, Oregon Health & Science University, Portland. 4. Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. 5. Academic Pediatric Association, McClean, Va. 6. Department of Pediatrics, Yale University, New Haven, Conn.
Abstract
OBJECTIVE: To survey newborn clinicians in the United States regarding the frequency of intramuscular (IM) vitamin K refusal by a parent, reasons for refusal, and approaches of clinicians to refusals. METHODS: An electronic survey was administered to the clinician site representative (nursery director or designee knowledgeable about site-specific nursery policies) at all newborn nurseries in the Better Outcomes through Research for Newborns (BORN) network of newborn nurseries. RESULTS: Of 92 BORN sites, 85 (92%) respondents completed the survey. Frequency of IM vitamin K refusal during the past 5 years was reported as increased by 52% of respondents, unchanged by 42%, and 6% did not know. Reported frequencies of refusal of IM vitamin K was weekly (9%), a few times a month (31%), once a month (13%), once every 3 to 4 months (20%), once or twice a year (26%), or never (1%). The overall distribution of the reported frequencies of refusal differed among regions in the United States (higher in the West and the South; P < .05). Reported reasons for refusal by parents included perceptions of parents that the injection was unnecessary, lack of knowledge about vitamin K deficiency bleeding, and concern about preservatives. Approaches to refusal included attempts to educate parents, enlisting support from community clinicians, a state mandate, and prescription of oral vitamin K. CONCLUSIONS: Respondents from a national sample of newborn nursery clinicians reported an increase in refusal of IM vitamin K in the past 5 years with regional variation. Approaches to refusals need further investigation to determine effectiveness.
OBJECTIVE: To survey newborn clinicians in the United States regarding the frequency of intramuscular (IM) vitamin K refusal by a parent, reasons for refusal, and approaches of clinicians to refusals. METHODS: An electronic survey was administered to the clinician site representative (nursery director or designee knowledgeable about site-specific nursery policies) at all newborn nurseries in the Better Outcomes through Research for Newborns (BORN) network of newborn nurseries. RESULTS: Of 92 BORN sites, 85 (92%) respondents completed the survey. Frequency of IM vitamin K refusal during the past 5 years was reported as increased by 52% of respondents, unchanged by 42%, and 6% did not know. Reported frequencies of refusal of IM vitamin K was weekly (9%), a few times a month (31%), once a month (13%), once every 3 to 4 months (20%), once or twice a year (26%), or never (1%). The overall distribution of the reported frequencies of refusal differed among regions in the United States (higher in the West and the South; P < .05). Reported reasons for refusal by parents included perceptions of parents that the injection was unnecessary, lack of knowledge about vitamin Kdeficiency bleeding, and concern about preservatives. Approaches to refusal included attempts to educate parents, enlisting support from community clinicians, a state mandate, and prescription of oral vitamin K. CONCLUSIONS: Respondents from a national sample of newborn nursery clinicians reported an increase in refusal of IM vitamin K in the past 5 years with regional variation. Approaches to refusals need further investigation to determine effectiveness.
Authors: Helen Bernhardt; David Barker; David M Reith; Roland S Broadbent; Pamela M Jackson; Benjamin J Wheeler Journal: J Paediatr Child Health Date: 2015-04-14 Impact factor: 1.954
Authors: Jaspreet Loyal; James A Taylor; Carrie A Phillipi; Neera K Goyal; Kelly E Wood; Carl Seashore; Beth King; Eve Colson; Veronika Shabanova; Eugene D Shapiro Journal: Pediatrics Date: 2018-08 Impact factor: 7.124