114 - Positive Effect of Aggressive Temperature Management Model on Core Temperature During Perioperative Period
Clinical Issue: Perioperative hypothermia could cause various serious side effects. Reducing the incidence of perioperative hypothermia has become a new clinical goal. Compared with the aggressive temperature management mode, which is more comprehensive and active, the traditional routine temperature management mode is still predominant in clinical practice. There is a need for actual data comparison to promote aggressive temperature management in the whole hospital. Description of Team:A young team made up of nursing professionals in the operating room striving for improvement in the operating room of Yinchuan First People's Hospital, Ningxia Hui Autonomous Region, Northwest China.Preparation and Planning:Plan to compare and analyze core temperature and other data of patients in the routine and aggressive temperature management groups; plan to establish and implement specific programs fit for the hospital to warm and protect the patients from perioperative hypothermiaSupport from hospital leaders and close cooperation from anesthesia and surgical teamsAdequate hands and clear division of labor in the projectPersonnel skilled in routine warming measuresFAW (forced-air warming) devices and consumables newly purchased
Assessment: A 10-day pre-test carried out to disclose problems and find corresponding solutionsImplementation:Data of 103 surgical patients in the hospital were collected from April 27 to May 30, 2018. Experimental data were collected and recorded: grouping, surgery type, age, gender, BMI, ASA score, surgery type, anesthesia method, anesthesia length, perioperative core temperature, post-operative situation, etc.Outcome:Aggressive temperature management significantly reduced the incidence of perioperative hypothermia: 23.5% in group A vs 59.6% in group R (P = 0.0002).Patients with ASA score of 2 were more likely to suffer from hypothermia when compared to those with ASA score of 1 in the routine group: 72.7% vs 40% (P = 0.0323).Postoperative discomfort (thirst, nausea, shivering and pain) and SSI were more frequently in patients with hypothermia than those with normothermia (51.2% vs 31.7%, P = 0.0462). The incidence of shivering was 14% vs 3.3% (P = 0.047) respectively in hypothermia and normothermia patients.Most of the lowest temperature time points of hypothermia patients were observed after the surgery, accounting for 66.7% in group A and 77.4% in group R.Implications for Perioperative Nursing:The value of the aggressive temperature management is recognized and promoted.In the future the perioperative core temperature monitoring, perioperative FAW operation, intraoperative fluid heating and high-risk population identification will be put into SOP. It is believed that the perioperative hypothermia rate can be reduced to lower than 10% to improve the experience and prognosis of surgical patients.