Skip to content

A quality improvement project to improve admission temperatures in very low birth weight infants.

CPQCC Publication
TitleA quality improvement project to improve admission temperatures in very low birth weight infants.
Publication TypeJournal Article
Year of Publication2008
AuthorsLee HC, Ho QT, Rhine WD
JournalJ Perinatol
Volume28
Issue11
Pagination754-8
Date Published2008 Nov
ISSN1476-5543
KeywordsHumans, Hypothermia, Infant, Newborn, Infant, Very Low Birth Weight, Medical Audit, Organizational Case Studies, Quality Assurance, Health Care, Quality Indicators, Health Care
Abstract

OBJECTIVE: To review the results of a quality improvement (QI) project to improve admission temperatures of very low birth weight inborn infants.

STUDY DESIGN: The neonatal intensive care unit at Lucile Packard Children's Hospital underwent a QI project to address hypothermic preterm newborns by staff education and implementing processes such as polyethylene wraps and chemical warming mattresses. We performed retrospective chart review of all inborn infants with birth weight <1500 g during the 18 months prior to (n=134) and 15 months after (n=170) the implementation period. Temperatures were compared between periods. Multivariable logistic regression was used to account for potential confounding variables. We compared mortality rates and grade 3 or 4 intraventricular hemorrhage rates between periods.

RESULT: The mean temperature rose from 35.4 to 36.2 degrees C (P<0.0001) after the QI project. The improvement was consistent and persisted over a 15-month period. After risk adjustment, the strongest predictor of hypothermia was being born in the period before implementation of the QI project (odds ratio 8.12, 95% confidence interval 4.63, 14.22). Although cesarean delivery was a strong risk factor for hypothermia prior to the project, it was no longer significant after the project. There was no significant difference in death or intraventricular hemorrhage detected between periods.

CONCLUSION: There was a significant improvement in admission temperatures after a QI project, which persisted beyond the initial implementation period. Although there was no difference in mortality or intraventricular hemorrhage rates, we did not have sufficient power to detect small differences in these outcomes.

DOI10.1038/jp.2008.92
Alternate JournalJ Perinatol
PubMed ID18580878
Grant List2T32 HD 07249-23 / HD / NICHD NIH HHS / United States