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A decreased body temperature can occur in patients with hypothermia and frostbite. Heat loss with extended cold exposure overpowers the body's ability to create heat, resulting in hypothermia. Core temperature readings help classify hypothermia. Mild hypothermia is temperatures between 32 °C (89.6 °F) and 35°C (95 °F) and is caused by impaired thermoregulation. Moderate hypothermia is temperatures between 28 C (82.4 °F) and 32 °C (89.6 °F) caused by...
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Pharmacological Methods of Reducing Fever:
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Esophageal Heat Transfer for Patient Temperature Control and Targeted Temperature Management
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Quality improvement sustainability to decrease utilization drift for therapeutic hypothermia in the NICU.

Hannah Kieffer1, Katherine Carlton2, Samuel Adams3

  • 1Medical College of Wisconsin, Milwaukee, WI, USA.

Journal of Perinatal Medicine
|March 28, 2023
PubMed
Summary
This summary is machine-generated.

Quality improvement methods sustained a decrease in therapeutic hypothermia (TH) misuse for hypoxic-ischemic encephalopathy (HIE) patients. This neuroprotection strategy showed lasting benefits despite inconsistent electronic documentation.

Keywords:
hypoxic-ischemic encephalopathyquality improvementtherapeutic hypothermiautilization drift

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Area of Science:

  • Neuroscience
  • Pediatrics
  • Quality Improvement Science

Background:

  • Therapeutic hypothermia (TH) is a standard neuroprotective treatment for moderate to severe hypoxic-ischemic encephalopathy (HIE).
  • Misuse of TH can lead to increased medical complications and healthcare costs.
  • Quality improvement (QI) methodologies are crucial for maintaining adherence to clinical guidelines and assessing intervention sustainability.

Purpose of the Study:

  • To evaluate the long-term sustainability of QI methods in reducing TH misuse.
  • To assess the impact of an electronic medical record-smart phrase (EMR-SP) intervention on TH adherence.
  • To investigate factors contributing to sustained improvements in TH application.

Main Methods:

  • This study represents Epoch 3 of a QI initiative, assessing the sustainability of previous interventions.
  • The intervention involved improving medical documentation using an EMR-SP to decrease TH misuse.
  • Data from 64 HIE patients were analyzed to evaluate TH appropriateness and documentation.

Main Results:

  • A sustained decrease in TH misuse was observed, with appropriate TH use in 66% of cases (33/50).
  • The average number of appropriate TH cases increased significantly from 1.9 in Epoch 2 to 9 in Epoch 3.
  • Inconsistent use of EMR-SP (68% documentation) did not negate the sustained reduction in TH misuse.

Conclusions:

  • QI methods have led to a sustained decrease in therapeutic hypothermia misuse for HIE.
  • Culture change and increased guideline awareness through education may be key drivers of lasting improvements.
  • Further research into optimizing documentation practices alongside educational interventions is warranted.