Preventing unplanned hypothermia A key component to patient safety

Abstract

There are many efforts focusing on patient safety and eliminating preventable surgical complications. The Joint Commission identifies National Patient Safety Goals each year.1 The Institute for Healthcare Improvement (IHI) initiated a 5 Million Lives Campaign in an effort to “protect patients from 5 million incidents of medical harm” over a 2-year period.2 The goal of the Surgical Care Improvement Project (SCIP) is to reduce surgical complications.3 One criteria in the SCIP is prevention of infections through implementation of SCIP #7, which notes that colorectal surgery patients receive “immediate postoperative normothermia.”4 According to the IHI, the national average of surgical site infections for “clean” cases is 2% to 3%, but 40% to 60% of these infections are identified as preventable when evidence-based care is implemented.2 One component is “immediate postoperative normothermia for colorectal surgery patients.”2 Two specialty nursing organizations have developed guidelines for the prevention of perioperative hypothermia. The American Society of PeriAnesthesia Nurses published a clinical practice guideline for the prevention of unplanned perioperative hypothermia. It was developed to provide a guide for the “prevention, care, and management of the adult surgical patient with unplanned perioperative hypothermia.”5 This comprehensive guideline includes management considerations in the perioperative, intraoperative, and postoperative settings. The Association of periOperative Registered Nurses also published Recommended Practices for the Prevention of Unplanned Perioperative Hypothermia. This describes an “optimal level of practice” and serves as a guide for the perioperative RN to prevent unplanned perioperative hypothermia in surgical patients.6 Every patient is at risk for complications when core body temperature decreases during a surgical procedure.7 These complications can be very costly. Hypothermia of only 1.5 °C below normal body temperature can result in several complications at a cost of $2,500 to $7,000 per surgical patient.5