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A Quality Improvement Initiative to Improve Perioperative Hypothermia Rates in the NICU Utilizing Checklists

Premature infants are at high risk for heat loss. Infants undergoing surgical procedures outside of the neonatal intensive care unit have an increased risk of hypothermia. Hypothermia can lead to delayed recovery, hypoglycemia, metabolic acidosis, sepsis, and emotional stress for the parents. We aim...

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Autores principales: Hanna, Morcos, Htun, Zeyar, Islam, Shahidul, Hanna, Nazeeh, Kothari, Ulka, Nayak, Amrita
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7470004/
https://www.ncbi.nlm.nih.gov/pubmed/33062906
http://dx.doi.org/10.1097/pq9.0000000000000367
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author Hanna, Morcos
Htun, Zeyar
Islam, Shahidul
Hanna, Nazeeh
Kothari, Ulka
Nayak, Amrita
author_facet Hanna, Morcos
Htun, Zeyar
Islam, Shahidul
Hanna, Nazeeh
Kothari, Ulka
Nayak, Amrita
author_sort Hanna, Morcos
collection PubMed
description Premature infants are at high risk for heat loss. Infants undergoing surgical procedures outside of the neonatal intensive care unit have an increased risk of hypothermia. Hypothermia can lead to delayed recovery, hypoglycemia, metabolic acidosis, sepsis, and emotional stress for the parents. We aimed to reduce the incidence of hypothermia for infants undergoing surgical procedures from a baseline of 44.4% to less than 25% over 3 years (2016–2018) with the utilization of a checklist and education. METHODS: We conducted a retrospective chart review for all infants undergoing surgical procedures from 2014 to 2015 and prospective data for 2016–2018. Next, we created a multidisciplinary team, educated staff members, and instituted a checklist comprising 9 tasks. We conducted Plan-Do-Study-Act cycles quarterly and audited checklist compliance monthly. RESULTS: From 2014 to 2015, the total incidence of perioperative hypothermia was 44.4% (n = 54). After the initiation of the checklist, the overall incidence of hypothermia decreased to 23.4% (n = 124, P = 0.007). Hypothermia occurred most frequently while the patient was in the operating room. Furthermore, we noticed that hypothermia was significantly associated with neonates requiring emergency procedures. There was an inverse correlation between overall compliance with checklist usage and the incidence of hypothermia. CONCLUSION: A checklist is a useful and simple tool for maintaining an optimal temperature for postsurgical neonates. Frequent re-education and enforcement of the protocol is necessary. Overall, implementation of the checklist, along with regular education, decreased the total incidence of perioperative hypothermia in the neonatal intensive care unit.
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spelling pubmed-74700042020-10-14 A Quality Improvement Initiative to Improve Perioperative Hypothermia Rates in the NICU Utilizing Checklists Hanna, Morcos Htun, Zeyar Islam, Shahidul Hanna, Nazeeh Kothari, Ulka Nayak, Amrita Pediatr Qual Saf Individual QI Projects from Single Institutions Premature infants are at high risk for heat loss. Infants undergoing surgical procedures outside of the neonatal intensive care unit have an increased risk of hypothermia. Hypothermia can lead to delayed recovery, hypoglycemia, metabolic acidosis, sepsis, and emotional stress for the parents. We aimed to reduce the incidence of hypothermia for infants undergoing surgical procedures from a baseline of 44.4% to less than 25% over 3 years (2016–2018) with the utilization of a checklist and education. METHODS: We conducted a retrospective chart review for all infants undergoing surgical procedures from 2014 to 2015 and prospective data for 2016–2018. Next, we created a multidisciplinary team, educated staff members, and instituted a checklist comprising 9 tasks. We conducted Plan-Do-Study-Act cycles quarterly and audited checklist compliance monthly. RESULTS: From 2014 to 2015, the total incidence of perioperative hypothermia was 44.4% (n = 54). After the initiation of the checklist, the overall incidence of hypothermia decreased to 23.4% (n = 124, P = 0.007). Hypothermia occurred most frequently while the patient was in the operating room. Furthermore, we noticed that hypothermia was significantly associated with neonates requiring emergency procedures. There was an inverse correlation between overall compliance with checklist usage and the incidence of hypothermia. CONCLUSION: A checklist is a useful and simple tool for maintaining an optimal temperature for postsurgical neonates. Frequent re-education and enforcement of the protocol is necessary. Overall, implementation of the checklist, along with regular education, decreased the total incidence of perioperative hypothermia in the neonatal intensive care unit. Lippincott Williams & Wilkins 2020-09-02 /pmc/articles/PMC7470004/ /pubmed/33062906 http://dx.doi.org/10.1097/pq9.0000000000000367 Text en Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Individual QI Projects from Single Institutions
Hanna, Morcos
Htun, Zeyar
Islam, Shahidul
Hanna, Nazeeh
Kothari, Ulka
Nayak, Amrita
A Quality Improvement Initiative to Improve Perioperative Hypothermia Rates in the NICU Utilizing Checklists
title A Quality Improvement Initiative to Improve Perioperative Hypothermia Rates in the NICU Utilizing Checklists
title_full A Quality Improvement Initiative to Improve Perioperative Hypothermia Rates in the NICU Utilizing Checklists
title_fullStr A Quality Improvement Initiative to Improve Perioperative Hypothermia Rates in the NICU Utilizing Checklists
title_full_unstemmed A Quality Improvement Initiative to Improve Perioperative Hypothermia Rates in the NICU Utilizing Checklists
title_short A Quality Improvement Initiative to Improve Perioperative Hypothermia Rates in the NICU Utilizing Checklists
title_sort quality improvement initiative to improve perioperative hypothermia rates in the nicu utilizing checklists
topic Individual QI Projects from Single Institutions
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7470004/
https://www.ncbi.nlm.nih.gov/pubmed/33062906
http://dx.doi.org/10.1097/pq9.0000000000000367
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