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- Title
Maintaining Normothermia in Preterm Babies during Stabilisation with an Intact Umbilical Cord.
- Authors
Cleator, Alexander James; Coombe, Emma; Alexopoulou, Vasiliki; Levingston, Laura; Evans, Kathryn; Hurst, Jonathan Christopher; Yoxall, Charles William
- Abstract
Background: We had experienced an increase in admission hypothermia rates during implementation of deferred cord clamping (DCC) in our unit. Our objective was to reduce the number of babies with a gestation below 32 weeks who are hypothermic on admission, whilst practising DCC and providing delivery room cuddles (DRC). Method: A 12 month quality improvement project set, in a large Neonatal Intensive Care Unit, from January 2020 to December 2020. Monthly rates of admission hypothermia (<36.5 °C) for all eligible babies, were tracked prospectively. Each hypothermic baby was reviewed as part of a series of Plan, Do, Study Act (PDSA) cycles, to understand potential reasons and to develop solutions. Implementation of these solutions included the dissemination of the learning through a variety of methods. The main outcome measure was the proportion of babies who were hypothermic (<36.5 °C) on admission compared to the previous 12 months. Results: 130 babies with a gestation below 32 weeks were admitted during the study period. 90 babies (69.2%) had DCC and 79 babies (60%) received DRC. Compared to the preceding 12 months, the rate of hypothermia decreased from 25/109 (22.3%) to 13/130 (10%) (p = 0.017). Only 1 baby (0.8%) was admitted with a temperature below 36 °C and 12 babies (9.2%) were admitted with a temperature between 36 °C and 36.4 °C. Continued monitoring during the 3 months after the end of the project showed that the improvements were sustained with 0 cases of hypothermia in 33 consecutive admissions. Conclusions: It is possible to achieve low rates of admission hypothermia in preterm babies whilst providing DCC and DRC. Using a quality improvement approach with PDSA cycles is an effective method of changing clinical practice to improve outcomes.
- Subjects
UNITED Kingdom; PREMATURE labor; INTENSIVE care units; PREGNANCY; UMBILICAL cord; HOSPITAL admission &; discharge; MEDICAL thermometry; NEONATAL intensive care; UMBILICAL cord clamping; NEONATAL intensive care units; GESTATIONAL age; MEDICAL thermometers; HYPOTHERMIA; QUALITY assurance; TEACHING aids; POSTNATAL care; RESUSCITATION
- Publication
Children, 2022, Vol 9, Issue 1, p75
- ISSN
2227-9067
- Publication type
Article
- DOI
10.3390/children9010075