Journal article
Effect of a thermal care bundle on the prevention, detection and treatment of perioperative inadvertent hypothermia
Journal of Clinical Nursing, Vol.27(5-6), pp.1239-1249
2018
PMID: 29149456
Abstract
Aims and objectives
To improve the prevention, detection and treatment of perioperative inadvertent hypothermia in adult surgical patients by implementing a Thermal Care Bundle.
Background
Keeping patients normothermic perioperatively prevents adverse surgical outcomes. Hypothermia leads to serious complications including increased risk of surgical bleeding, surgical site infections and morbid cardiac events. The Thermal Care Bundle consists of three elements: (i) assess risk; (ii) record temperature; and (iii) actively warm.
Design
A pre‐ and postimplementation study was conducted to determine the impact of the Thermal Care Bundle on the prevention, detection and treatment of perioperative inadvertent hypothermia.
Methods
The Thermal Care Bundle was implemented using an adapted version of the Institute of Healthcare Improvement's Breakthrough Series Collaborative Model. Data were collected from auditing medical records.
Results
Data from 729 patients (pre‐implementation: n = 351; postimplementation: n = 378) at four sites were collected between December 2014–January 2016. Improvements were recorded in the percentage of patients with a risk assessment; at least one documented temperature recording per perioperative stage; and appropriate active warming. Despite this, the overall incidence of perioperative inadvertent hypothermia increased postimplementation.
Conclusion
The Thermal Care Bundle facilitated improved management of perioperative inadvertent hypothermia through increased risk assessment, temperature recording and active warming but did not impact on perioperative inadvertent hypothermia incidence. Increased temperature recording may have more accurately revealed the true extent of perioperative inadvertent hypothermia in this population.
Relevance to clinical practice
This study showed that a collaborative, context specific implementation method, such as the IHI Breakthrough Series Model, is effective at improving practices, which can improve thermal care.
Details
- Title
- Effect of a thermal care bundle on the prevention, detection and treatment of perioperative inadvertent hypothermia
- Authors
- Jed Duff (Corresponding Author) - University of Newcastle AustraliaKim Walker - St Vincent’s Private Hospital SydneyKaren‐Leigh Edward - Swinburne University of TechnologyNicholas Ralph - University of Southern QueenslandJo‐Ann Giandinoto - St Vincent’s Private Hospital SydneyKimberley Alexander - Queensland University of TechnologyJeff Gow - University of KwaZulu-NatalJohn Stephenson - University of Huddersfield
- Publication details
- Journal of Clinical Nursing, Vol.27(5-6), pp.1239-1249
- Publisher
- Wiley-Blackwell Publishing Ltd.
- Date published
- 2018
- DOI
- 10.1111/jocn.14171
- ISSN
- 1365-2702
- PMID
- 29149456
- Grant note
- St Vincent’s Clinic Foundation Multidisciplinary Patient Focused Research Grant and support from 3M, Device Technology and Molnlycke Health Care
- Organisation Unit
- School of Health
- Language
- English
- Record Identifier
- 991087294602621
- Output Type
- Journal article
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4 Record Views
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web Of Science research areas
- Nursing
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Source: InCites