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Esophageal Heat Transfer for Patient Temperature Control and Targeted Temperature Management
Published on: November 21, 2017
Goal-oriented temperature management in severely traumatized children in the emergency department: a best practice
Wenchao Wang1, Yanhong Zhang1, Fang Ling1
1Emergency Department, Children's Hospital of Fudan University, Shanghai, China.
Insights
Hypothermia prevention in trauma patients improved significantly through evidence-based practices. Goal-oriented temperature management strategies and staff training reduced hypothermia incidence in severely injured children.
Area of Science:
- Medical Research
- Evidence-Based Practice Implementation
- Trauma Care
Background:
- Hypothermia is a common complication in trauma patients.
- Adherence to evidence-based hypothermia prevention practices in emergency departments is inconsistent.
- This study addresses the need for improved temperature management in severely traumatized children.
Purpose of the Study:
- To assess compliance with evidence-based practices for goal-oriented temperature management in severely traumatized children.
- To identify barriers to implementing best practices in hypothermia prevention.
- To evaluate the effectiveness of an implementation strategy in improving compliance.
Main Methods:
- Utilized the JBI Evidence Implementation Framework and the i-PARIHS framework.
- Developed a goal-oriented temperature management strategy, simulation training, and ensured supply of warming materials.
- Assessed compliance through field observation, medical record review, and interviews before and after intervention.
Main Results:
- Compliance with all 12 audited criteria increased significantly from baseline to follow-up.
- Shivering and cold discomfort scores decreased post-intervention.
- Hypothermia was prevented in all surviving patients.
Conclusions:
- The JBI Evidence Implementation Framework effectively improved compliance with evidence-based hypothermia prevention practices.
- Sustained adherence requires ongoing audits and reinforcement of evidence-based behaviors.
- The implemented strategy successfully reduced hypothermia in severely traumatized children.
Introduction And Objectives:
Hypothermia commonly occurs in trauma patients. Evidence-based practices for hypothermia prevention are not strictly followed by all medical staff in the emergency department. This study aimed to assess compliance with evidence-based practices regarding goal-oriented temperature management for severely traumatized children in a Chinese hospital.
Methods:
This project used the JBI Evidence Implementation Framework to translate evidence into practice. The Integrated-Promoting Action on Research Implementation in Health Services (i-PARIHS) framework was used to identify barriers to compliance with best practices. A goal-oriented temperature management strategy for trauma patients was developed based on the identified barriers, along with a simulation training module, and the supply of warming materials. Field observation, review of medical records, and interviews with medical staff and patients were used to assess baseline and follow-up audit compliance with best practices.
Results:
Twelve criteria were audited in the baseline and follow-up audits, with 11 and 37 trauma patients, respectively. In the follow-up audit, compliance with all criteria increased, with a reduction in shivering and cold discomfort scores. Except for two patients who died, hypothermia did not occur in any of the patients.
Conclusions:
The JBI Evidence Implementation Framework was used to successfully improve compliance with best practices. Future audits should be conducted to sustain the evidence-based behavior of all medical staff.
Spanish Abstract:
http://links.lww.com/IJEBH/A234.
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