Reducing Transitional Hypothermia in Outborn Very Low Birth Weight Infants.
BACKGROUND
Transitional hypothermia (TH) is associated with increased morbidity and mortality in very low birth weight (VLBW) infants worldwide.


OBJECTIVE
To assess the effect of a quality improvement project (QIP) on outborn TH and the associated mortality/morbidity among VLBW neonates.


METHODS
We conducted a multi-intervention QIP to reduce TH (<36°C) among outborn VLBW neonates. This cohort study compared a historical group (group I, n = 86) to a prospective group (group II, established after QIP implementation, n = 86). The primary outcome was axillary temperature measured in the delivery room (DR) and upon admission to the neonatal intensive care unit (NICU).


RESULTS
The baseline characteristics of the two groups were similar. After introducing the QIP, the mean DR and NICU admission temperatures of the patients rose from 35.5 to 36.1°C and from 34.6 to 36.2°C, respectively (p < 0.01), and the percentage of patients with temperatures <36°C in the DR and NICU decreased from 80 to 40% and from 81 to 42% (p < 0.01), respectively. Meanwhile, the percentage of patients with a normal temperature in the DR and NICU rose from 20 to 58% and from 19 to 56% (p < 0.01), respectively, which was accompanied by significantly decreased mortality (p < 0.02) and other improvements.


CONCLUSIONS
Implementation of a QIP resulted in a decrease in the number of moderately hypothermic VLBW neonates and a sustained improvement in normothermia rates during DR stabilization and transfer to the NICU in outborn VLBW neonates.
Department of Neonatology, Children's Hospital of Fudan University, Shanghai, PR China.
Haiqing
H
Leng
Haiyan
H
Wang
Biyun
B
Lin
Guoqiang
G
Cheng
Laishuan
L
Wang
D002681:China; D003696:Delivery Rooms / Q000458:organization & administration; D005260:Female; D006801:Humans; D007035:Hypothermia / Q000628:therapy*; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal / Q000458:organization & administration*; D008297:Male; D009017:Morbidity; D017063:Outcome Assessment, Health Care; D010360:Patient Transfer; D011446:Prospective Studies; D011785:Quality Assurance, Health Care