Increasing Ambient Operating Room Temperatures to Decrease Hypothermia in Preterm Neonates

Abstract

Problem: Preterm neonates (≤32 weeks postmenstrual age [PMA] or ≤1500 grams [g]) frequently experience hypothermia or cold stress at time of delivery because of the low ambient air temperatures in the operating room (OR). There is a correlation between an admission temperature below 36.5°C and neurological injury, retinopathy of prematurity, intraventricular hemorrhage, and mortality. Evidence demonstrates that an OR temperature 73°F-77°F prevents hypothermia and cold stress of preterm neonates. A chart audit performed in 2022 illustrated that between 2/12/2022 and 3/23/2022, six preterm neonates within criteria had an average admission temperature of 36.1°C, with the ambient OR temperature being 68°F-72°F. The purpose of this quality improvement (QI) project is to increase the ambient temperatures of both ORs to at least 73°F-77°F to prevent neonatal hypothermia in preterm neonates <32 weeks’ GA or <1500g. Methods: The temperatures of both ORs were preset to 73°F by the building operations center (BOC) and consistent for all births. The day shift charge nurse recorded both daily OR temperatures from the temperature display in the OR. During the first seven weeks of implementation and for the remaining weeks the BOC provided both OR temperatures because they were more accurate. The temperatures were updated retroactively. A “Temperature Collection” Survey was completed by the charge nurse when a neonate within criteria was born to assess the OR temperature at delivery and the neonatal admission temperature. Results: There were 14 births within the 15 weeks of implementation. Over 92% of the neonates were euthermic (36.5°C–37.5°C). Conclusion: Increasing the ambient temperatures of both ORs to at least 72-73°F decreased neonatal hypothermia in 92 percent of the preterm neonates ≤32 weeks PMA or ≤1500g.