Documentation of Core Temperature in Pediatric Patients Undergoing General Anesthesia: A Quality Improvement Initiative to Increase Compliance.

Abstract

Background: Children's body composition makes them highly susceptible to heat loss, which is further amplified by anesthetic-induced inhibition of thermoregulatory control. Perioperative hypothermia can lead to adverse outcomes, thus highlighting the importance of core temperature monitoring for pediatric patients undergoing general anesthesia. We launched and completed a quality improvement (QI) initiative at our institution starting in February 2023, with the SMART aim to increase the percentage of pediatric patients in our dental OR who receive a documented core temperature in the anesthetic record from 10% to 60% by October 2023.

Methods: We referenced the Standards for Quality Improvement Reporting Excellence guidelines and used the Model for Improvement with interventions tested via Plan-Do-Study-Act cycles. We tested 5 interventions between February and October 2023. These included an educational email to all anesthesia professionals, a posted sign in the OR, a Morbidity and Mortality Conference regarding core temperature monitoring, and the development of an integrated pop-up reminder to measure core temperature in our electronic healthcare record.

Results: With this QI initiative, the percentage of pediatric patients undergoing general anesthesia for more than an hour in our dental OR with documented core temperature monitoring increased from 10% to 60% by October 2023, and to 90% by January 2024.

Conclusions: We successfully increased compliance with standard ASA monitoring guidelines. By January 2024, 90% of pediatric patients undergoing general anesthesia for more than an hour in our dental OR had documented core temperature monitoring in the anesthetic record.