遠隔軍事治療施設における周術期偶発性低体温症への取り組み：術前加温プロトコルの実施

The purpose of this quality improvement project was to implement a prewarming protocol to reduce rates of inadvertent perioperative hypothermia (IPH).

Quality improvement project using the Johns Hopkins Model for Evidence-Based Practice as a framework.

An interdisciplinary team implemented an evidence-based prewarming protocol using forced-air warmers to reduce rates of IPH. We collected preintervention data for 30 days before implementation and 30 days during implementation. Anesthesia technicians prewarmed patients for a target time of 30 minutes before surgery. We measured protocol adherence, temperature trends, and unintended costs or delays due to prewarming. Data were analyzed using descriptive statistics, the independent t test, χ², and Pearson correlation.

A total of 63 patients were observed during the preintervention and intervention phases of the project over 2 months. Prewarming was associated with a 42.8% drop in IPH. Prewarmed patients experienced significantly less IPH and were warmer on arrival to the postanesthesia care unit than non-prewarmed patients. Prewarmed patients who experienced IPH recovered to normothermia significantly faster than non-prewarmed patients.

Prewarming is an evidence-based intervention associated with a reduction in the incidence of IPH across the perioperative care continuum. Implementing prewarming as a part of preoperative care can be done successfully as a quality improvement project with the aid of an evidence-based practice model.