Prevention of Admission Hypothermia in Low-Birth- Weight Infants Through PDSA Cycle of Quality Improvement Initiative

Abstract

Background: Admission hypothermia (AH) is one of the key indicators in quality care of preterm infants. Unfortunately, AH rate in the authors’ institution was rather high. Therefore, the authors had set up quality improvement initiatives to improve rate of AH in the authors’ institution. The present study aimed to assess the effectiveness of the authors’ quality improvement initiatives (QI) to reduce admission hypothermia (AH) in infants less than 2,000 g. Materials and Methods: The present study was a retrospective evaluation of the authors’ QI program. The enrolled infants were inborn with birthweight less than 2,000 g, admitted in the NICU directly after birth. The QI consisted of increasing resuscitation area temperature (RT), use of heat protective measures, and transported with prewarmed transport incubator. To assess effectiveness, rate of admission hypothermia and admission temperature (AT) were selected as QI outcomes. The outcomes were compared between pre-QI period and post-QI period. Results: There were 117 and 133 infants in pre-QI and post-QI period, respectively. RT were 24.7±1.48℃ and 24.8±1.04℃,AT increased from 36.4±0.85℃ to 36.7±0.60℃ and incidence of hypothermia were decreased from 50.4% to 30.8%, in pre and post QI period (p-value<0.05). Conclusion: The authors’ QI effectively reduced AH in infants under 2,000 g. Keywords: Preterm; Hypothermia; Quality improvement