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Related Experiment Video

Updated: Feb 11, 2026

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Use of Plan-Do-Study-Act cycles to decrease incidence of neonatal hypothermia in the labor room.

Subhash Chandra Shaw1, Amit Devgan2, Sushila Anila3

  • 1Assistant Professor, Department of Pediatrics, Armed Forces Medical College, Pune 411040, India.

Medical Journal, Armed Forces India
|April 26, 2018
PubMed
Summary

Neonatal hypothermia is a serious risk, but a quality improvement initiative successfully reduced its incidence to zero in newborns delivered vaginally. This initiative ensured all neonates maintained normal body temperature after birth.

Keywords:
Neonatal hypothermiaPlan-Do-Study-ActQuality improvementSkin to skin contact

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Area of Science:

  • Neonatal care
  • Quality Improvement in Healthcare
  • Perinatal Medicine

Background:

  • Neonatal hypothermia (<36.5°C) is a significant risk factor for increased mortality and morbidity in newborns.
  • Despite known risks, neonatal temperature management remains under-addressed in clinical practice.
  • Baseline data indicated a 50% incidence of hypothermia in neonates at 1 hour post-vaginal delivery.

Purpose of the Study:

  • To implement a quality improvement initiative to reduce neonatal hypothermia.
  • To decrease the incidence of hypothermia in term and late preterm neonates at 1 hour after vaginal delivery from 50% to less than 10% within 6 weeks.

Main Methods:

  • A rapid-cycle Plan-Do-Study-Act (PDSA) improvement model was utilized.
  • The initiative targeted singleton neonates (gestational age >34 weeks) born via vaginal delivery, excluding those requiring resuscitation or NICU support.
  • PDSA cycles included interventions such as pre-warmed cloths, skin-to-skin care, delayed weight checks, and a planned steps checklist.

Main Results:

  • After four PDSA cycles, the incidence of neonatal hypothermia at 1 hour post-birth dropped from 50% to 0%.
  • Sustained 100% of neonates maintained a normal body temperature (36.5-37.5°C) following the intervention.
  • The study included 46 neonates over a 6-week period.

Conclusions:

  • This quality improvement project effectively reduced neonatal hypothermia in term and late preterm neonates born via vaginal delivery.
  • The rapid-cycle PDSA approach proved successful in achieving and sustaining target temperature goals.
  • The findings highlight the importance of proactive temperature management in the delivery room.