115 - Bundle Measures to Reduce the Incidence of Perioperative Hypothermia in Parturient Undergoing Caesarean Section
Clinical Issue: Perioperative Hypothermia in Parturient Undergoing C-SectionTeam
Introduction: We are from the operating room of the First People's Hospital of Yancheng, China. There are 4 members in the team , OR Head Nurse: Lu Zhaorong, nurse: Zhang Xuejuan, Liu Yawen, physician: Li Feng. Preparation and Planning For women who need C-Section, perioperative hypothermia is a common surgical complication due to the combined effects of anesthesia, amniotic fluid outflow, fetal delivery and other factors. We plans to reduce the incidence of hypothermia and chills during perioperative period by means of QCC. We collected 46 cases of lying-in women who underwent cesarean section in our hospital in 2018 as control group, and explored the causes of hypothermia and improvement measures, and implemented the improvement. We collected 46 parturients who underwent caesarean section in our hospital from February to June 2019 as intervention group, and determined the effectiveness of intervention measures via comparing the data.Evaluation Assessment of Environment: policies and regulations ,Collection of samples Assessment of Patients: Inclusion&ExclusionEvaluation on materials: hardwareAssessment of Operators: be trainedImplementation We reviewed the perioperative temperature data of women undergoing C- section in 2018, as well as the perioperative warming measures. It was found that most of women with low-temperature lacked sufficient time of active warming during the perioperative period.After 2 rounds discussions, we worked out bundle interventions: the pre-warming of pregnant women with forced-air blanket immediately after entering the operating room and lasted during the operation process until post-operation; we upgraded the drapes in the operation of pregnant women, which was replaced by single use water-proof drapes with intraoperative liquid collection function. We provided psychological comfort to patients before surgery to relieve their tension, and requested that the operating room temperature must be kept at 23 degrees Celsius. Relevant data were collected and analyzed statistically after the implementation of intervention measures. Results The incidence of hypothermia of perioperative parturients decreased from 39.13% before the intervention to 8.69% after it (P=0.001, P<0.05, there were differences between the two groups). The incidence of postoperative shivering of parturients decreased from 43.47% before the intervention to 17.39% after it (P<0.001, P<0.05, there were differences between the two groups). The overall satisfaction of parturients increased from 78.26% before the intervention to 95.65% after it ( P < 0.05, there were differences between the two groups). Conclusion Active inflated blanket warming and pre-warming before induction of anesthesia can significantly reduce the incidence of perioperative hypothermia and shivering. Meanwhile, due to the large flow of amniotic fluid during the operation, single use and water proof drapes with liquid collection function can avoid body heat from being taken away via evaporation. Additionally, the psychological comfort of the parturients can reduce the subjective feeling of cold caused by the tension of the parturients after the operation.