Implementation of a multidisciplinary guideline improves preterm infant admission temperatures

Background:hypothermia is a common problem in preterm infants immediately following delivery.local problem:the rate of admission hypothermia in our neonatal intensive care unit (nicu) was above the rate of comparable nicus in the vermont oxford network.methods:to reduce the rate of preterm admission hypothermia, a quality improvement (qi) project was implemented, utilizing the plan-do-study-act (pdsa) methodology. a guideline for delivery room thermoregulation management in <35-week infants at the university of virginia was created and put into practice by a multidisciplinary team.interventions:clinical practice changes in the guideline included: increasing operating room temperatures, obtaining a 10-min axillary temperature, using an exothermic mattress for all infants <35 weeks, and using a polyethylene wrap for infants <32 weeks.results:the baseline rate of hypothermia (<36.5 °cc) was 63%. three pdsa cycles data were completed on 168 consecutive preterm births. the post-implementation rate of hypothermia (<36.5 °c) was reduced to 30% (p<0.001). the incidence of moderate hypothermia (< 36 °c) was reduced from a baseline of 29% to a rate of 9% (p<0.001).conclusion:use of a multidisciplinary guideline to increase preterm nicu admission temperatures resulted in a decrease in hypothermic infants.