To study effectiveness of quality improvement interventions in reducing hypothermia in preterm infants on admission to neonatal intensive care unit. Quality improvement methodologies including multidisciplinary planning and implementation of evidence-based interventions. Data during and post-implementation were collected. In total, 84 preterm infants with birth weights <= 1500 g delivered during implementation period (October 2008-April 2009) were compared with 168 historical controls and 947 infants in the subsequent 4 years. In addition to routine interventions, delivery room temperatures were increased, and use of full-body polyethylene wraps and woollen caps were implemented during initial stabilization. Education and training were provided to reinforce the new interventions. Primary outcome was incidence of hypothermia and mean admission temperature. Secondary outcomes were rates of intraventricular haemorrhage and mortality. Incidence of admission hypothermia decreased from 79.4 to 40.5% (P < 0.001), constituting a 49% improvement (OR = 0.177, 95% CI: 0.099-0.316). Mean admission temperature increased from 35.8 +/- 0.8A degrees C to 36.5 +/- 0.7A degrees C (P < 0.001). Hyperthermia incidence was higher at 6% compared to baseline of 1.3% (P = 0.049). The incidence of admission hypothermia remained stable at 47.4% in the 4 years post-implementation. Rates of intraventricular haemorrhage and mortality remained unchanged. Small for gestation, low 5-min Apgar score and singleton delivery were factors found to be associated with admission hypothermia. The implementation of evidence-based best practices resulted in significant reduction in admission hypothermia in preterm infants, which persisted for 4 years post-implementation. The practices have since become standard of care in our institution.
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页码:922 / 928
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[1]
[Anonymous], 1997, Thermal Protection of the Newborn: A Practical Guide
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Univ London Imperial Coll Sci Technol & Med, Ctr Patient Safety & Serv Qual, Dept Surg & Canc, Fac Med, London W2 1PG, EnglandUniv London Imperial Coll Sci Technol & Med, Ctr Patient Safety & Serv Qual, Dept Surg & Canc, Fac Med, London W2 1PG, England
Benn, J.
;
Arnold, G.
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Imperial Coll Healthcare NHS Trust, Ctr Perioperat Med & Crit Care Res, London, EnglandUniv London Imperial Coll Sci Technol & Med, Ctr Patient Safety & Serv Qual, Dept Surg & Canc, Fac Med, London W2 1PG, England
Arnold, G.
;
Wei, I.
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h-index: 0
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Univ London Imperial Coll Sci Technol & Med, Ctr Patient Safety & Serv Qual, Dept Surg & Canc, Fac Med, London W2 1PG, EnglandUniv London Imperial Coll Sci Technol & Med, Ctr Patient Safety & Serv Qual, Dept Surg & Canc, Fac Med, London W2 1PG, England
Wei, I.
;
Riley, C.
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机构:
Imperial Coll Healthcare NHS Trust, Dept Anaesthet, London, EnglandUniv London Imperial Coll Sci Technol & Med, Ctr Patient Safety & Serv Qual, Dept Surg & Canc, Fac Med, London W2 1PG, England
Riley, C.
;
Aleva, F.
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h-index: 0
机构:
Radboud Univ Nijmegen, Med Ctr, IQ Sci Inst Qual Healthcare, NL-6525 ED Nijmegen, NetherlandsUniv London Imperial Coll Sci Technol & Med, Ctr Patient Safety & Serv Qual, Dept Surg & Canc, Fac Med, London W2 1PG, England
机构:
Univ Fed Sao Paulo, Escola Paulista Med, Div Neonatal Med, Sao Paulo, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Div Neonatal Med, Sao Paulo, Brazil
Branco de Almeida, Maria Fernanda
;
Guinsburg, Ruth
论文数: 0引用数: 0
h-index: 0
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Univ Fed Sao Paulo, Escola Paulista Med, Div Neonatal Med, Sao Paulo, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Div Neonatal Med, Sao Paulo, Brazil
Guinsburg, Ruth
;
Sancho, Guilherme Assis
论文数: 0引用数: 0
h-index: 0
机构:
Univ Fed Sao Paulo, Escola Paulista Med, Div Neonatal Med, Sao Paulo, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Div Neonatal Med, Sao Paulo, Brazil
Sancho, Guilherme Assis
;
Machado Rosa, Izilda Rodrigues
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h-index: 0
机构:
Univ Estadual Campinas, Hosp Mulher Prof Dr Jose Aristodemo Pinotti, Dept Pediat, Campinas, SP, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Div Neonatal Med, Sao Paulo, Brazil
Machado Rosa, Izilda Rodrigues
;
Lamy, Zeni Carvalho
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h-index: 0
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Univ Fed Maranhao, Univ Hosp, Dept Publ Hlth, Sao Luis, MA, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Div Neonatal Med, Sao Paulo, Brazil
Lamy, Zeni Carvalho
;
Martinez, Francisco Eulogio
论文数: 0引用数: 0
h-index: 0
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Univ Sao Paulo, Hosp Clin Ribeirao Preto, Dept Pediat, BR-14049 Ribeirao Preto, SP, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Div Neonatal Med, Sao Paulo, Brazil
Martinez, Francisco Eulogio
;
Vieira Cavalcante da Silva, Regina Paula Guimaraes
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机构:
Univ Fed Parana, Hosp Clin, Dept Pediat, BR-80060000 Curitiba, Parana, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Div Neonatal Med, Sao Paulo, Brazil
Vieira Cavalcante da Silva, Regina Paula Guimaraes
;
Lopes Ferrari, Ligia Silvana
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h-index: 0
机构:
Univ Estadual Londrina, Univ Hosp, Dept Pediat & Pediat Surg, Londrina, PR, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Div Neonatal Med, Sao Paulo, Brazil
Lopes Ferrari, Ligia Silvana
;
Suppo de Souza Rugolo, Ligia Maria
论文数: 0引用数: 0
h-index: 0
机构:
Univ Estadual Paulista, Fac Med Botucatu, Dept Pediat, Botucatu, SP, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Div Neonatal Med, Sao Paulo, Brazil
Suppo de Souza Rugolo, Ligia Maria
;
Steffen Abdallah, Vania Olivetti
论文数: 0引用数: 0
h-index: 0
机构:
Univ Fed Uberlandia, Hosp Clin, Dept Pediat, BR-38400 Uberlandia, MG, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Div Neonatal Med, Sao Paulo, Brazil
Steffen Abdallah, Vania Olivetti
;
Silveira, Rita de Cassia
论文数: 0引用数: 0
h-index: 0
机构:
Univ Fed Rio Grande do Sul, Hosp Clin, Dept Pediat, Porto Alegre, RS, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Div Neonatal Med, Sao Paulo, Brazil
机构:
Wayne State Univ, Div Neonatal Perinatal Med, Hutzel Womens Hosp, Detroit, MI 48201 USAWayne State Univ, Div Neonatal Perinatal Med, Hutzel Womens Hosp, Detroit, MI 48201 USA
Chawla, S.
;
Amaram, A.
论文数: 0引用数: 0
h-index: 0
机构:
Wayne State Univ, Div Neonatal Perinatal Med, Hutzel Womens Hosp, Detroit, MI 48201 USAWayne State Univ, Div Neonatal Perinatal Med, Hutzel Womens Hosp, Detroit, MI 48201 USA
Amaram, A.
;
Gopal, S. P.
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机构:
Wayne State Univ, Div Neonatal Perinatal Med, Hutzel Womens Hosp, Detroit, MI 48201 USAWayne State Univ, Div Neonatal Perinatal Med, Hutzel Womens Hosp, Detroit, MI 48201 USA
Gopal, S. P.
;
Natarajan, G.
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机构:
Wayne State Univ, Div Neonatal Perinatal Med, Hutzel Womens Hosp, Detroit, MI 48201 USAWayne State Univ, Div Neonatal Perinatal Med, Hutzel Womens Hosp, Detroit, MI 48201 USA
机构:
Complementary and Alternative Research and Education Program, Department of Pediatrics, University of Alberta, Edmonton, Alta. T6G 2J3Complementary and Alternative Research and Education Program, Department of Pediatrics, University of Alberta, Edmonton, Alta. T6G 2J3
Cramer K.
;
Wiebe N.
论文数: 0引用数: 0
h-index: 0
机构:
Department of Medicine, Division of Nephrology, University of Alberta, Edmonton, Alta. T6G 2J3Complementary and Alternative Research and Education Program, Department of Pediatrics, University of Alberta, Edmonton, Alta. T6G 2J3
Wiebe N.
;
Hartling L.
论文数: 0引用数: 0
h-index: 0
机构:
Alberta Research Centre for Child Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, Alta. T6G 2J3Complementary and Alternative Research and Education Program, Department of Pediatrics, University of Alberta, Edmonton, Alta. T6G 2J3
Hartling L.
;
Crumley E.
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Complementary and Alternative Research and Education Program, Department of Pediatrics, University of Alberta, Edmonton, Alta. T6G 2J3Complementary and Alternative Research and Education Program, Department of Pediatrics, University of Alberta, Edmonton, Alta. T6G 2J3
机构:
Otto Von Guericke Univ, Zentrum Kinderheilkunde, D-39112 Magdeburg, GermanyOtto Von Guericke Univ, Zentrum Kinderheilkunde, D-39112 Magdeburg, Germany
Gleissner, M
;
Jorch, G
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Otto Von Guericke Univ, Zentrum Kinderheilkunde, D-39112 Magdeburg, GermanyOtto Von Guericke Univ, Zentrum Kinderheilkunde, D-39112 Magdeburg, Germany
Jorch, G
;
Avenarius, S
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Otto Von Guericke Univ, Zentrum Kinderheilkunde, D-39112 Magdeburg, GermanyOtto Von Guericke Univ, Zentrum Kinderheilkunde, D-39112 Magdeburg, Germany
机构:
Univ London Imperial Coll Sci Technol & Med, Ctr Patient Safety & Serv Qual, Dept Surg & Canc, Fac Med, London W2 1PG, EnglandUniv London Imperial Coll Sci Technol & Med, Ctr Patient Safety & Serv Qual, Dept Surg & Canc, Fac Med, London W2 1PG, England
Benn, J.
;
Arnold, G.
论文数: 0引用数: 0
h-index: 0
机构:
Imperial Coll Healthcare NHS Trust, Ctr Perioperat Med & Crit Care Res, London, EnglandUniv London Imperial Coll Sci Technol & Med, Ctr Patient Safety & Serv Qual, Dept Surg & Canc, Fac Med, London W2 1PG, England
Arnold, G.
;
Wei, I.
论文数: 0引用数: 0
h-index: 0
机构:
Univ London Imperial Coll Sci Technol & Med, Ctr Patient Safety & Serv Qual, Dept Surg & Canc, Fac Med, London W2 1PG, EnglandUniv London Imperial Coll Sci Technol & Med, Ctr Patient Safety & Serv Qual, Dept Surg & Canc, Fac Med, London W2 1PG, England
Wei, I.
;
Riley, C.
论文数: 0引用数: 0
h-index: 0
机构:
Imperial Coll Healthcare NHS Trust, Dept Anaesthet, London, EnglandUniv London Imperial Coll Sci Technol & Med, Ctr Patient Safety & Serv Qual, Dept Surg & Canc, Fac Med, London W2 1PG, England
Riley, C.
;
Aleva, F.
论文数: 0引用数: 0
h-index: 0
机构:
Radboud Univ Nijmegen, Med Ctr, IQ Sci Inst Qual Healthcare, NL-6525 ED Nijmegen, NetherlandsUniv London Imperial Coll Sci Technol & Med, Ctr Patient Safety & Serv Qual, Dept Surg & Canc, Fac Med, London W2 1PG, England
机构:
Univ Fed Sao Paulo, Escola Paulista Med, Div Neonatal Med, Sao Paulo, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Div Neonatal Med, Sao Paulo, Brazil
Branco de Almeida, Maria Fernanda
;
Guinsburg, Ruth
论文数: 0引用数: 0
h-index: 0
机构:
Univ Fed Sao Paulo, Escola Paulista Med, Div Neonatal Med, Sao Paulo, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Div Neonatal Med, Sao Paulo, Brazil
Guinsburg, Ruth
;
Sancho, Guilherme Assis
论文数: 0引用数: 0
h-index: 0
机构:
Univ Fed Sao Paulo, Escola Paulista Med, Div Neonatal Med, Sao Paulo, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Div Neonatal Med, Sao Paulo, Brazil
Sancho, Guilherme Assis
;
Machado Rosa, Izilda Rodrigues
论文数: 0引用数: 0
h-index: 0
机构:
Univ Estadual Campinas, Hosp Mulher Prof Dr Jose Aristodemo Pinotti, Dept Pediat, Campinas, SP, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Div Neonatal Med, Sao Paulo, Brazil
Machado Rosa, Izilda Rodrigues
;
Lamy, Zeni Carvalho
论文数: 0引用数: 0
h-index: 0
机构:
Univ Fed Maranhao, Univ Hosp, Dept Publ Hlth, Sao Luis, MA, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Div Neonatal Med, Sao Paulo, Brazil
Lamy, Zeni Carvalho
;
Martinez, Francisco Eulogio
论文数: 0引用数: 0
h-index: 0
机构:
Univ Sao Paulo, Hosp Clin Ribeirao Preto, Dept Pediat, BR-14049 Ribeirao Preto, SP, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Div Neonatal Med, Sao Paulo, Brazil
Martinez, Francisco Eulogio
;
Vieira Cavalcante da Silva, Regina Paula Guimaraes
论文数: 0引用数: 0
h-index: 0
机构:
Univ Fed Parana, Hosp Clin, Dept Pediat, BR-80060000 Curitiba, Parana, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Div Neonatal Med, Sao Paulo, Brazil
Vieira Cavalcante da Silva, Regina Paula Guimaraes
;
Lopes Ferrari, Ligia Silvana
论文数: 0引用数: 0
h-index: 0
机构:
Univ Estadual Londrina, Univ Hosp, Dept Pediat & Pediat Surg, Londrina, PR, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Div Neonatal Med, Sao Paulo, Brazil
Lopes Ferrari, Ligia Silvana
;
Suppo de Souza Rugolo, Ligia Maria
论文数: 0引用数: 0
h-index: 0
机构:
Univ Estadual Paulista, Fac Med Botucatu, Dept Pediat, Botucatu, SP, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Div Neonatal Med, Sao Paulo, Brazil
Suppo de Souza Rugolo, Ligia Maria
;
Steffen Abdallah, Vania Olivetti
论文数: 0引用数: 0
h-index: 0
机构:
Univ Fed Uberlandia, Hosp Clin, Dept Pediat, BR-38400 Uberlandia, MG, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Div Neonatal Med, Sao Paulo, Brazil
Steffen Abdallah, Vania Olivetti
;
Silveira, Rita de Cassia
论文数: 0引用数: 0
h-index: 0
机构:
Univ Fed Rio Grande do Sul, Hosp Clin, Dept Pediat, Porto Alegre, RS, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Div Neonatal Med, Sao Paulo, Brazil
机构:
Wayne State Univ, Div Neonatal Perinatal Med, Hutzel Womens Hosp, Detroit, MI 48201 USAWayne State Univ, Div Neonatal Perinatal Med, Hutzel Womens Hosp, Detroit, MI 48201 USA
Chawla, S.
;
Amaram, A.
论文数: 0引用数: 0
h-index: 0
机构:
Wayne State Univ, Div Neonatal Perinatal Med, Hutzel Womens Hosp, Detroit, MI 48201 USAWayne State Univ, Div Neonatal Perinatal Med, Hutzel Womens Hosp, Detroit, MI 48201 USA
Amaram, A.
;
Gopal, S. P.
论文数: 0引用数: 0
h-index: 0
机构:
Wayne State Univ, Div Neonatal Perinatal Med, Hutzel Womens Hosp, Detroit, MI 48201 USAWayne State Univ, Div Neonatal Perinatal Med, Hutzel Womens Hosp, Detroit, MI 48201 USA
Gopal, S. P.
;
Natarajan, G.
论文数: 0引用数: 0
h-index: 0
机构:
Wayne State Univ, Div Neonatal Perinatal Med, Hutzel Womens Hosp, Detroit, MI 48201 USAWayne State Univ, Div Neonatal Perinatal Med, Hutzel Womens Hosp, Detroit, MI 48201 USA
机构:
Complementary and Alternative Research and Education Program, Department of Pediatrics, University of Alberta, Edmonton, Alta. T6G 2J3Complementary and Alternative Research and Education Program, Department of Pediatrics, University of Alberta, Edmonton, Alta. T6G 2J3
Cramer K.
;
Wiebe N.
论文数: 0引用数: 0
h-index: 0
机构:
Department of Medicine, Division of Nephrology, University of Alberta, Edmonton, Alta. T6G 2J3Complementary and Alternative Research and Education Program, Department of Pediatrics, University of Alberta, Edmonton, Alta. T6G 2J3
Wiebe N.
;
Hartling L.
论文数: 0引用数: 0
h-index: 0
机构:
Alberta Research Centre for Child Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, Alta. T6G 2J3Complementary and Alternative Research and Education Program, Department of Pediatrics, University of Alberta, Edmonton, Alta. T6G 2J3
Hartling L.
;
Crumley E.
论文数: 0引用数: 0
h-index: 0
机构:
Complementary and Alternative Research and Education Program, Department of Pediatrics, University of Alberta, Edmonton, Alta. T6G 2J3Complementary and Alternative Research and Education Program, Department of Pediatrics, University of Alberta, Edmonton, Alta. T6G 2J3
机构:
Otto Von Guericke Univ, Zentrum Kinderheilkunde, D-39112 Magdeburg, GermanyOtto Von Guericke Univ, Zentrum Kinderheilkunde, D-39112 Magdeburg, Germany
Gleissner, M
;
Jorch, G
论文数: 0引用数: 0
h-index: 0
机构:
Otto Von Guericke Univ, Zentrum Kinderheilkunde, D-39112 Magdeburg, GermanyOtto Von Guericke Univ, Zentrum Kinderheilkunde, D-39112 Magdeburg, Germany
Jorch, G
;
Avenarius, S
论文数: 0引用数: 0
h-index: 0
机构:
Otto Von Guericke Univ, Zentrum Kinderheilkunde, D-39112 Magdeburg, GermanyOtto Von Guericke Univ, Zentrum Kinderheilkunde, D-39112 Magdeburg, Germany