Implementation of thermoregulation bundle to improve admission temperature in preterm infants and their outcomes

Abstract

Introduction: Preterm infants' thermoregulation in the first few minutes after birth remains a contentious issue, but studies show that focusing on the issue and developing a guideline can reduce hypothermia in these patients. By implementing the thermoregulation bundle, this study aims to reduce the incidence of hypothermia on admission to the neonatal intensive care unit (NICU) by 50% in infants born at 32 weeks' gestation or less. Materials and Methods: Neonatology unit at a private medical college in the Chennai district was studied for 6 months from July 2021 to December 2021. The Plan-Do-Study-Act cycle from the “WHO Point-of-Care Quality Improvement Model” was used. Thermoregulation bundle was used to standardize thermoregulation management from predelivery through admission to the NICU. Results: The NICU temperature had spiked significantly to 36.38°C ± 0.67°C (P < 0.001) from the previous two readings, which was statistically significant (P = 0.001). Results from Bonferroni corrections show that the temperature induced during implementation had a statistically significant increase in temperature (23°C vs. 34°C, respectively) from the delivery point to the point of baby shifting (P = 0.001) which accounted for a 67% reduction of hypothermia. Conclusion: The present study successfully achieved its objective of reducing hypothermia by more than 50%, with a rate of 67%. Premature infants can be saved from hypothermia by implementing a standard protocol in the delivery room at the time of baby transfer and admission to the NICU.