Preventing Intraoperative and Postoperative Hypothermia

Abstract

Problem: Hypothermia is defined as a core body temperature of less than 96.8 °F. The prevalence of perioperative hypothermia has been reported to be in the range of 50% -90% of patients undergoing surgical procedures. In a community-based hospital, the quality benchmark for perioperative temperature monitoring and management is 98%. Currently, compliance for perioperative temperature monitoring and management is only 64% presenting an opportunity to improve perioperative hypothermia management. Purpose: The purpose of this performance improvement project was to implement evidence-based warming bundle interventions to prevent intraoperative and postoperative hypothermia on a patient undergoing elective surgery receiving general and/or regional anesthesia in a community-based hospital. Methods: The setting for this performance improvement project was perioperative area of a community-based hospital. The target population included anesthesia providers and perioperative nurses. The use of warming interventions provided by these professional was considered for adult patients over the age of 18 years and undergoing elective surgery under general and/or regional anesthesia for more than 60 minutes. Anesthesia providers provided forced-air warming blankets, warm blankets, and humidifier filter when intubated to eligible patients. Further, eligible patients were administered warmed intravenous fluids. Assessment of compliance of using warming bundle intervention by anesthesia providers was based on completion of a self-reported data collection sheet. Results: A total of 245 data collection sheets were collected from September-November 2020. Seventy- seven percent (188/245) utilized the warming bundle intervention, 9% (23/245) used only forced-air warming devices, and 14% (34/245) utilized passive warming. Among warming bundle intervention, in 91% (172/188) of cases, forced air warming blanket along with passive warming methods were used and 9% (16/188) utilized warming bundle intervention along with warm intravenous fluids. Thus, the compliance with the warming bundle intervention by the anesthesia providers was 77%. Further, the patients treated with warming intervention maintained the intraoperative and postoperative temperature ≥ 97 °F. Conclusions: The warming bundle intervention is successful in preventing intraoperative and postoperative hypothermia in a patient undergoing elective surgery under general and/or regional anesthesia at the community-based hospital. Hospital compliance for perioperative temperature monitoring and management was also increased by using warming interventions.