STEPP IN: Working Together to Keep Infants Warm in the Perioperative Period

Area of Science:

• Pediatric critical care medicine
• Neonatalogy
• Patient safety research

Background:

• Postoperative hypothermia is a significant risk in neonatal intensive care units (NICUs).
• Effective strategies are needed to prevent heat loss in neonates during surgical procedures.

Purpose of the Study:

• To reduce postoperative hypothermia by up to 50% in children's hospital NICUs over 12 months.
• To identify specific clinical practices that contribute to successful hypothermia reduction.

Main Methods:

• A literature review, expert opinion, and benchmarking informed clinical practice recommendations.
• Recommendations focused on establishing euthermia before OR transport, standardized transport practices, and preventing intraoperative heat loss.
• Multivariable logistic regression analyzed factors impacting hypothermia rates.

Main Results:

• Postoperative hypothermia decreased by 48% (from 20.3% to 10.5%).
• High compliance with maintaining euthermia upon OR arrival (OR: 0.58) and departure (OR: 0.73) was associated with reduced hypothermia.
• Prewarming the OR to >74°F also correlated with decreased hypothermia (OR: 0.78).

Conclusions:

• Reducing postoperative hypothermia in neonates is achievable through targeted interventions.
• Key practices include prewarming the operating room and ensuring consistent euthermia throughout the perioperative period.