Document Type

DNP Project

Publication Date

2020

Disciplines

Nursing

Abstract

Background: The implementation of a standardized warming protocol aims to prevent hypothermia in the postoperative period. Hypothermia in the postoperative period can result in inadvertent adverse outcomes for patients undergoing surgical procedures. In 2011, The Joint Commission (TJC) and Center for Medicare and Medicaid (CMS) issued the Surgical Care Improvement Project (SCIP) Inf-10 guidelines, known as the body temperature management guidelines, to decrease morbidity and mortality in surgical patients undergoing general anesthesia. These guidelines recommend using an active warming system, such as the 3MTM Bair Hugger TM System to warm patients intraoperatively.

Review of Literature: Randomized control trials (RCTs) and meta-analysis were included as part of the literature review with the use of Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Collaboration and Medline databases.

Purpose: In this study, the research aims to evaluate the effectiveness of preventing hypothermia in a hospital that adopted the evidence-based body temperature management guidelines.

Methods: The author retrospectively analyzed a total of 243 medical records, which included 158 paper medical records and 85 electronic medical records using the hospital’s information management system. As part of the study, two groups, each consisting of 50 patient medical records meeting inclusion criteria, were analyzed. A total of 108 paper medical records and 85 electronic medical records were excluded from the study for not meeting criteria.

Results: Patients were randomized and divided into two groups. Group A (n=50) consisting of patients who did not receive active warming in 2010, and Group B (n=50) consisting of patients who received the active warming intervention in 2020. Group B revealed a mean body temperature that was 0.1° Celsius higher than Group A. At the end of surgery, Group A demonstrated nearly a 15% higher incidence of hypothermia when compared to Group B. Descriptive statistics were analyzed using an independent sample t-test, assuming unequal variance for the two groups. There was a statistically significant difference between the two groups (P < 0.028). The study’s results support the use of forced air warming (FAW) in the intraoperative period as an effective way of preventing postoperative hypothermia in the Post Anesthesia Care Unit (PACU).

Implications/Conclusion: This study assessed the effectiveness of SCIP Inf-10 guidelines in preventing hypothermia in patients undergoing surgical procedures. Prior to 2011, there were no recommendations issued by TJC or CMS to actively warm patients. Active warming, as characterized by the 3MTM Bair Hugger TM System warming system has been shown to be decrease morbidity and mortality, surgical site infections and other complications. Group B, which consisted of patients having undergone surgical procedures in 2020, were actively warmed and experienced a 0% incidence of hypothermia. Group A, which consisted of patients having undergone surgery before the release of SCIP Inf-10 guidelines, experienced nearly a 15% incidence of hypothermia. It is reasonable to conclude that the utilization of body temperature management guidelines is effective in preventing hypothermia in patients undergoing surgical procedures.

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Copyright Esmeralda Espinoza

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