Testing Proposed National Guidelines for Perioperative Normothermia
Uniformed Services University Of The Health Sci Bethesda United States
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Unintentional perioperative hypothermia is an unwanted but common occurrence during anesthesia. A national multidisciplinary panel developed the National Perioperative Thermoregulation Guidelines NPTG directed at maintaining patient normothermia perioperatively by identifying preoperative risk factors, and instituting active warming measures early. The purpose of the study was to pilot test the proposed guidelines to identify barriers to implementation, and suggestions for improvement. Data were collected by perioperative health care providers in the ambulatory surgery unit ASU, operating rooms OR, and post-anesthesia care unit PACU for all scheduled surgeries over a period of two weeks. The sample consisted of 98 n115 of patients undergoing surgery. The ASU reported on 55 patients 48, the OR 92 patients 80, and the PACU 90 patients 78. Twenty-four percent n13 of preoperative patients were found to be hypothermic in the ASU before surgery. Seventy-one percent of patients did not have a temperature recorded postoperatively in the ASU prior discharge, and of those recorded 29 n16, one-half were discharged from ASU hypothermic. Thirty-three percent n30 of patients arrived in the PACU hypothermic from the OR, and 50n15 of these patients were discharged from the PACU hypothermic. ASU, OR, and PACU staff reported that the NPTG were not difficult to follow, yet apparently NPTG were not implemented or followed. No barriers to implementation were identified by ASU or PACU staff. OR staff identified four barriers to implementation, and one suggestion for improvement to NPTG.