A multimodal quality improvement approach to promote normothermia in very preterm infants. (14th July 2021)

• Record Type: Journal Article
• Authors: Young, Aneurin; Azeez, Fameesh; Godad, Santan Pawalu; Shetty, Preethish; Sharma, Alok
• Is Part Of: Acta pædiatrica. Volume 110:Number 10(2021)
• Page Start: 2745
• Page End: 2752
• Publication Date: 2021-07-14
• Subjects: hyperthermia -- hypothermia -- normothermia -- preterm -- quality improvement; Pediatrics -- Periodicals; Pediatrics; 618.92
• DOI: 10.1111/apa.16009
• Languages: English
• ISSNs: 0803-5253

Abstract

Abstract: Aim: To achieve the National Neonatal Audit Programme (NNAP) standard of 90% normothermia among preterm infants born under 30 weeks of gestation. Methods: Project SHIP (Stopping Hypothermia In Premmies) was a quality improvement programme to improve admission normothermia. Phase 1 of the project implemented low‐fidelity simulations during 2011–2016. In Phase 2 (2017), a multimodal approach to quality improvement was used, including in situ simulations, videos of simulated scenarios, an allocated team member for thermal care, a clear protocol for thermal care, a coordinating 'lollipop man' role and monthly performance feedback. Additionally, continuous temperature monitoring using servo‐control during stabilisation was introduced during Phase 2. Phase 3 (2018–2019) focused on embedding practice and maintaining performance. Results: Phase 1 initiatives resulted in improvement of normothermia rates from 58% to 75%. However, the results plateaued. During Phase 2, the hypothermia rate fell from 16% to 3%. During Phase 3, this improvement in the hypothermia rate was sustained, achieving the standard of 90% normothermia in 2018 and falling just short in 2019 due to an increased hyperthermia rate. Conclusion: A multimodal quality improvement approach achieved sustained improvement in normothermia. Continuous temperature monitoring during stabilisation allows resuscitating teams to plan interventions to treat hypothermia and hyperthermia.