In:
jpme, Walter de Gruyter GmbH, Vol. 41, No. 4 ( 2013-07-01), p. 455-460
Abstract:
Objective: To reduce the incidence of hypothermia (admission temperatures 〈 36°C) in extremely low birth weight (ELBW) neonates using a multi-intervention quality improvement (QI) initiative. Study design: We conducted a multi-intervention QI initiative to reduce hypothermia (admission temperatures 〈 36°C) among preterm ELBW (≤1000 g birth weight) neonates born at Hutzel Women’s Hospital. The QI project was conducted in three periods: period 1, traditional thermal care of drying and wrapping in towel; period 2, wrapping in plastic wrap without first drying; and period 3, periodic staff education, additional use of chemical warming mattress, and increase in operating room temperature from 20°C to 21°C. Statistical analysis included ANOVA, χ 2 , and logistic regression as appropriate. Results: In our cohort of 209 patients, baseline characteristics were comparable in the three periods except for a reduction in the need for surfactant doses in the 3 rd period. Temperature on admission to the neonatal intensive care unit was significantly higher, with a reduction in hypothermia in the 3 rd period. There was no patient with a temperature of ≥37.5°C. On logistic regression, with gestational age, 5-min Apgar score, and mode of delivery as covariates, time period 3 was significantly associated with a reduction in the incidence of hypothermia (P=0.02). Conclusion: A concerted QI approach improved admission temperature in ELBW neonates, with more neonates in the euthermic range, without increasing the risk for hyperthermia. Such an approach could be associated with improved outcomes in this population.
Type of Medium:
Online Resource
ISSN:
1619-3997
,
0300-5577
DOI:
10.1515/jpm-2012-0259
Language:
English
Publisher:
Walter de Gruyter GmbH
Publication Date:
2013
detail.hit.zdb_id:
1467968-1
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