The impact of a quality improvement effort in reducing admission hypothermia in preterm infants following delivery.
10.3345/kjp.2018.61.8.239
- Author:
Han Saem CHOI
1
;
Soon Min LEE
;
Hoseon EUN
;
Minsoo PARK
;
Kook In PARK
;
Ran NAMGUNG
Author Information
1. Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea. ranng@yuhs.ac
- Publication Type:Original Article
- Keywords:
Hypothermia;
Preterm infants;
Pulmonary haemorrhage;
Quality improvement;
Very low birth weight infants
- MeSH:
Birth Weight;
Body Temperature;
Delivery Rooms;
Fever;
Gestational Age;
Hemorrhage;
Humans;
Hypothermia*;
Incidence;
Infant;
Infant, Newborn;
Infant, Premature*;
Infant, Very Low Birth Weight;
Intensive Care, Neonatal;
Mortality;
Qi;
Quality Improvement*
- From:Korean Journal of Pediatrics
2018;61(8):239-244
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Hypothermia at admission is associated with increased mortality and morbidity in preterm infants. We performed a quality improvement (QI) effort to determine the impact of a decrease in admission hypothermia in preterm infants. METHODS: The study enrolled very low birth weight (VLBW) infants born at Gangnam Severance Hospital between January 2013 and December 2016. This multidisciplinary QI effort included the use of occlusive wraps, warm blankets, and caps; the delivery room temperature was maintained above 23.0℃, and a check-list was used for feedback. RESULTS: Among 259 preterm infants, the incidence of hypothermia (defined as body temperature <36.0℃) decreased significantly from 68% to 41%, and the mean body temperature on neonatal intensive care unit admission increased significantly from 35.5℃ to 36.0℃. In subgroup analysis of VLBW infants, admission hypothermia and neonatal outcomes were compared between the pre-QI (n=55) and post-QI groups (n=75). Body temperature on admission increased significantly from 35.4℃ to 35.9℃ and the number of infants with hypothermia decreased significantly from 71% to 45%. There were no cases of neonatal hyperthermia. The incidence of pulmonary hemorrhage was significantly decreased (P=0.017). Interaction analysis showed that birth weight and gestational age were not correlated with hypothermia following implementation of the protocol. CONCLUSION: Our study demonstrated a significant reduction in admission hypothermia following the introduction of a standardized protocol in our QI effort. This resulted in an effective reduction in the incidence of massive pulmonary hemorrhage.
