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A Quality Improvement Initiative to Improve Perioperative Hypothermia Rates in the NICU Utilizing Checklists

Morcos Hanna1, Zeyar Htun2, Shahidul Islam3

  • 1Department of Pediatrics, NYU Winthrop Hospital, Mineola, N.Y.

Pediatric Quality & Safety
|October 16, 2020
PubMed

Insights

A checklist and education initiative significantly reduced hypothermia in infants undergoing surgery, lowering incidence from 44.4% to 23.4%. This improved patient temperature management and recovery outcomes.

Area of Science:

  • Neonatal intensive care
  • Surgical patient safety
  • Pediatric hypothermia prevention

Background:

  • Premature infants and neonates undergoing surgery face significant risks of heat loss and hypothermia.
  • Hypothermia in surgical neonates is linked to delayed recovery, metabolic issues, sepsis, and parental stress.
  • Baseline incidence of perioperative hypothermia in infants was 44.4%.

Purpose of the Study:

  • To decrease the incidence of hypothermia in infants undergoing surgical procedures.
  • Targeted reduction from 44.4% to below 25% within three years (2016-2018).
  • Evaluate the effectiveness of a checklist and education intervention.

Main Methods:

  • Retrospective and prospective chart review (2014-2018).
  • Implementation of a multidisciplinary team, staff education, and a 9-task checklist.
  • Utilized Plan-Do-Study-Act cycles and monthly audits of checklist compliance.

Main Results:

  • Post-intervention hypothermia incidence decreased to 23.4% (P = 0.007).
  • Hypothermia was most common in the operating room and associated with emergency procedures.
  • Higher checklist compliance correlated with lower hypothermia rates.

Conclusions:

  • A checklist is an effective tool for maintaining normothermia in postsurgical neonates.
  • Sustained implementation requires ongoing staff re-education and protocol enforcement.
  • The intervention successfully reduced overall perioperative hypothermia in the neonatal intensive care unit.

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