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Decreasing Variation to Enhance Accurate Identification of Hypothermic Infants in Pediatric Primary Care

Mary Carol Burkhardt1,2, Haley Schlottmann1, Allison Reyner3

  • 1Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

Clinical Pediatrics
|September 15, 2023
PubMed

Insights

Hypothermia in infants can signal sepsis. This study standardized care in pediatric offices, significantly reducing low temperatures in infants aged 0-49 days and improving management of at-risk newborns.

Area of Science:

  • Pediatrics
  • Neonatal Care
  • Quality Improvement

Background:

  • Hypothermia is a critical early sign of sepsis in young infants.
  • Standardized management protocols for infant hypothermia in primary care are lacking.
  • Infants aged 0-49 days are particularly vulnerable.

Purpose of the Study:

  • To standardize the identification and management of infants at risk of hypothermia in pediatric primary care settings.
  • To decrease the incidence of infant temperatures ≤36.5°C from 24% to 10% within two years.
  • To improve the care pathway for newborns presenting with hypothermia.

Main Methods:

  • Implementation of a quality improvement project with a SMART (Specific, Measurable, Achievable, Relevant, Time-bound) aim.
  • Standardization of protocols for identifying and managing infants with temperatures ≤36.5°C.
  • Staff training and empowerment for consistent care delivery.

Main Results:

  • Documented temperatures ≤36.5°C decreased from 24% to 7% of encounters.
  • Overall incidence of temperatures ≤36.5°C was 13.4% (1078/8020 infants).
  • 96.1% of infants with hypothermia were rewarmed in the office; 31 required hospitalization.

Conclusions:

  • Quality improvement initiatives effectively reduce hypothermia in infants within primary care.
  • Standardized care, staff empowerment, and appropriate triage improve outcomes for at-risk infants.
  • The study successfully decreased low temperatures and optimized care for newborns.

Keywords:
hypothermialow temperatureoffice managementpediatricsprimary carequality improvement

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