Quality Improvement Intervention Lowers Hypothermia Rates in Preterm Infants in a Resource-Limited Setting.

Area of Science:

• Neonatal Medicine
• Quality Improvement Science
• Public Health

Background:

• Admission hypothermia poses a significant threat to preterm neonates, particularly in resource-limited settings.
• Effective thermoregulation is critical for neonatal survival and well-being.

Purpose of the Study:

• To evaluate the impact of a quality improvement (QI) initiative on thermoregulation in preterm neonates.
• To reduce the prevalence of hypothermia in a resource-constrained neonatal intensive care unit (NICU).

Main Methods:

• A quasi-experimental pre-post study design was employed.
• The study compared preterm infants (gestational age < 33 weeks or birth weight < 1500g) admitted before and after the QI intervention.
• The primary outcome measured was hypothermia prevalence (temperature < 36.5°C) within the first hour of life.

Main Results:

• The QI initiative reduced hypothermia prevalence from 82.5% to 68.2% (p=0.047).
• Median admission temperature increased from 35.3°C to 35.8°C (p=0.013).
• Post-intervention hypothermia was associated with increased mortality (PR=3.27, p=0.017).

Conclusions:

• Targeted QI measures effectively improved thermal outcomes for preterm neonates in a resource-limited NICU.
• Despite improvements, persistent hypothermia underscores the need for continued efforts in neonatal care.
• Enhancing neonatal care practices is crucial for improving survival rates in vulnerable populations.