Improving thermoregulation in transported preterm infants: a quality improvement initiative

Area of Science:

• Neonatalogy
• Pediatric Transport Medicine
• Quality Improvement Science

Background:

• Maintaining normothermia in preterm and low birth weight (LBW) infants during transport is critical for their survival and well-being.
• Previous transport protocols showed that only 60% of these vulnerable infants were admitted within the target temperature range of 36.5-37.5°C.

Purpose of the Study:

• To increase the percentage of transported preterm or LBW infants admitted with a temperature of 36.5-37.5°C from 60% to 80% by December 2017.
• To implement and evaluate quality improvement interventions focused on maintaining normothermia in transported neonates.

Main Methods:

• A Model for Improvement framework utilizing Plan-Do-Study-Act (PDSA) cycles was employed.
• Interventions included standardizing isolette temperatures, using chemical warming packs and plastic wrap, enhancing awareness, and providing feedback on temperature monitoring.
• Data were collected for 381 infants transported between January 2016 and December 2019 and analyzed using p-charts.

Main Results:

• The baseline normothermia rate was 60%.
• Following interventions, the rate of infants admitted within the target temperature range increased to 80% by June 2018 and further to 96% by April 2019.
• No increase in hyperthermia was observed during the improvement period.

Conclusions:

• Multidisciplinary quality improvement initiatives were effective in significantly improving normothermia rates in vulnerable transported infants.
• Sustained efforts led to achieving and exceeding the target normothermia rate, reaching 96% without adverse effects.