A Quality Improvement Intervention to Decrease Hypothermia in the Delivery Room Using a Checklist.

Area of Science:

• Neonatal care
• Clinical quality improvement
• Pediatric medicine

Background:

• Premature infants (<32 weeks gestation) face significant hypothermia risks in the delivery room.
• Delivery room environmental factors can exacerbate hypothermia and lead to complications.
• Neonatal hypothermia is defined as a core body temperature below 97°F.

Purpose of the Study:

• To implement and assess a delivery room checklist to reduce neonatal hypothermia.
• To achieve and sustain a hypothermia rate below 40% in premature infants.
• To evaluate the checklist's impact on hypothermia over a 6-month period and beyond.

Main Methods:

• A delivery room checklist was developed in 2012.
• Baseline hypothermia rates were established through chart review.
• The checklist's effectiveness and compliance were monitored from 2012 to 2018, with statistical analysis using Chi-square and Fisher's exact tests.

Main Results:

• Hypothermia decreased from a baseline of 50% in 2011 to 33% in 2012.
• After initial success, hypothermia rates fluctuated, reaching 44% in 2014.
• Reinforced checklist use and interventions led to a significant reduction to 14% by 2018.

Conclusions:

• A simple checklist can drive beneficial practice changes in clinical settings.
• The checklist proved effective in decreasing the proportion of neonatal hypothermia.
• Sustained use and reinforcement are key to maintaining improvements in neonatal care.