G375 Get set for labour ward. optimising temperature management in preterm infants (<32 weeks gestation). (12th March 2018)

• Record Type: Journal Article
• Authors: Duggan, MI; Rennie, C; Nicholl, C; Brownell, M; Sexton, L; O'Shea, J; Heuchan, AM
• Is Part Of: Archives of disease in childhood. Volume 103(2018)Supplement 1
• Page Start: A152
• Page End: A152
• Publication Date: 2018-03-12
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2018-rcpch.364
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Aim: To design and implement a quality improvement project to optimise normothermia (36.5°C–37.5°C) in preterm infants on admission to neonatal intensive care (NICU). Methods: A prospective audit of admission temperatures over a 12 month period from 01/01/2016 to 31/12/2016 revealed 25 (31%) infants&lt;32 weeks gestation were hypothermic on admission despite routine use of plastic bags and radiant heaters at delivery. A bundle of evidence based processes was compiled. These were based on NLS guidance of optimal environmental temperature, use of warmed mattresses, plastic wrapping, warmed incubators and warmed humidified gases. Also included was the American Academy of Paediatric guidance on the use continuous temperature monitoring at resuscitation. The bundle: &#39;Get S aturation E cg T emperature for labour ward&#39; was implemented following staff education, including advice on improving temperature if low on monitoring during stabilisation. A Lifestart trolley was used to deliver stabilisation with the cord intact for 60 s and monitoring was with Philips XDS monitors. Compliance with the number of process measures were recorded by questionnaire following each delivery and admission axillary temperature recorded. Results: Since implementation of Get SET in June 2017, 32 preterm infants&lt;32 weeks have been admitted to NICU. 26 (81%) were normothermic, 4 (13%) were hypothermic and 2 (6%) were hyperthermic. 75% of the hypothermic infants had an admission temperature &gt;36°C and no infant had an admission temperature &lt;35.9°C (table 1). Bundle compliance was not followed in 3 out of the 4 cases of hypothermic admissions, the remaining case was a prolonged breech delivery. Bundle compliance overall was 82%. Conclusion: Quality improvement measures implemented to actively monitor and maintain temperatures in the normothermic range during stabilisation increased the proportion of preterm infants admitted with temperatures in the optimal range.