Monday 24 June 2019

N VIT K NUDGE

It's OK to Nudge for Vitamin K

First published: 17 June 2019
 
This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1111/apa.14905

Abstract

Aim

To propose a theoretical framework of factors that are likely to influence parental refusal to administer an intramuscular Vitamin K injection in newborns to prevent Vitamin K deficiency bleeding

Methods

The literature was reviewed on the risks and benefits of Vitamin K prophylaxis, the pathophysiology of Vitamin K deficiency bleeding, the elements of a robust informed refusal, and the ways in which cognitive biases can prevent an informed decision. This information was then synthesized into an ethical framework for the clinician's use of nudging in the clinical decision‐making process.

Results

Cognitive biases involved in decisions about Vitamin K injections can be systematically addressed by nudges in the clinical setting to increase the rates of Vitamin K prophylaxis.

Conclusion

We conclude that repeated, yet careful and respectful nudging throughout pregnancy and birth, may help combat natural biases and empower mothers to make the healthiest decisions for their babies.

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