Document Detail


Improving admission temperature in extremely low birth weight infants: a hospital-based multi-intervention quality improvement project.
MedLine Citation:
PMID:  23334053     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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, χ2, 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 3rd period. Temperature on admission to the neonatal intensive care unit was significantly higher, with a reduction in hypothermia in the 3rd 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.
Authors:
Zeenia Billimoria; Sanjay Chawla; Monika Bajaj; Girija Natarajan
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-19
Journal Detail:
Title:  Journal of perinatal medicine     Volume:  -     ISSN:  1619-3997     ISO Abbreviation:  J Perinat Med     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0361031     Medline TA:  J Perinat Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  1-6     Citation Subset:  -    
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