title: Evidence utilisation project: Management of inadvertent perioperative hypothermia. The challenges of implementing best practice recommendations in the perioperative environment.
abstract: OBJECTIVE
  The prevention of inadvertent perioperative hypothermia (IPH) remains an important issue in perioperative healthcare. The aims of this project were to: (i) assess current clinical practice in the management of IPH and (ii) promote best practice in the management of IPH in adult operating theatres.
  
  
  METHODS
  This project from August 2010 to March 2012 utilised a system of audit and feedback to implement best practice recommendations. Data were collected via chart audits against criteria developed from best practice recommendations for managing IPH. Evidence-based best practices, such as consistent temperature monitoring and patient warming, were implemented using multifaceted interventions.
  
  
  RESULTS
  Perioperative records for 73 patients (baseline) and 72 patients (post-implementation) were audited. Post-implementation audit showed an increase in patients with temperatures >36°C admitted to the post-anaesthetic care unit (PACU) (8%) and discharged from PACU (28%). The percentage of patients receiving preoperative temperature monitoring increased (38%); however, low levels of intraoperative monitoring remained (31% of patients with surgery of 30 min or longer duration). Small increases were found in patient warming of 5% intraoperatively and 8% postoperatively. Preoperative warming was not successfully implemented during this phase of the project.
  
  
  CONCLUSIONS
  Temperature monitoring, warming and rates of normothermia improved; however, barriers to best practice of IPH management were experienced, which negatively impacted on the project. Further stages of implementation and audit were added to further address IPH management in this department.
authors.affiliation: Nursing Research Centre / Queensland Centre for Evidence-Based Nursing and Midwifery, Queensland University of Technology, Brisbane, Queensland, Australia; School of Nursing & Midwifery, Queensland University of Technology, Brisbane, Queensland, Australia.
authors.forename: Judy
authors.initials: J
authors.lastname: Munday
authors.forename: Sonia Jane
authors.initials: SJ
authors.lastname: Hines
authors.forename: Anne M
authors.initials: AM
authors.lastname: Chang
mesh_terms: D001831:Body Temperature; D002985:Clinical Protocols; D019317:Evidence-Based Medicine; D006801:Humans; D007035:Hypothermia / Q000453:epidemiology* / Q000628:therapy*; D007431:Intraoperative Complications; D008991:Monitoring, Physiologic; D059035:Perioperative Period
keywords: best practice; evidence utilisation; hypothermia; perioperative; temperature monitoring