A clinical audit cycle of post-operative hypothermia in dogs.
OBJECTIVE
Use of clinical audits to assess and improve perioperative hypothermia management in client-owned dogs.


METHODS
Two clinical audits were performed. In Audit 1 data were collected to determine the incidence and duration of perioperative hypothermia (defined as rectal temperatures <37·0°C). The results from Audit 1 were used to reach consensus on changes to be implemented to improve temperature management, including re-defining hypothermia as rectal temperature <37·5°C. Audit 2 was performed after 1 month with changes in place.


RESULTS
Audit 1 revealed a high incidence of post-operative hypothermia (88·0%) and prolonged time periods (7·5 hours) to reach normothermia. Consensus changes were to use a forced air warmer on all dogs and measure rectal temperatures hourly post-operatively until temperature ≥37·5°C. After 1 month with the implemented changes, Audit 2 identified a significant reduction in the time to achieve a rectal temperature of ≥37·5°C, with 75% of dogs achieving this goal by 3·5 hours. The incidence of hypothermia at tracheal extubation remained high in Audit 2 (97·3% with a rectal temperature <37·5°C).


CONCLUSIONS
Post-operative hypothermia was improved through simple changes in practice, showing that clinical audit is a useful tool for monitoring post-operative hypothermia and improving patient care. Overall management of perioperative hypothermia could be further improved with earlier intervention.
Western Veterinary Specialist and Emergency Centre, Calgary, Alberta T3C 0J8, Canada.
N
N
Rose
Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta T2N 4Z6, Canada.
G P S
GP
Kwong
Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta T2N 4N1, Canada.|Veterinary Clinical and Diagnostic Sciences, Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta T2N 4Z6, Canada.
D S J
DS
Pang
D000416:Alberta; D000818:Animals; D002985:Clinical Protocols; D004283:Dog Diseases / Q000517:prevention & control*; D004285:Dogs; D005260:Female; D007035:Hypothermia / Q000517:prevention & control / Q000662:veterinary*; D007431:Intraoperative Complications / Q000517:prevention & control / Q000662:veterinary*; D008297:Male; D008485:Medical Audit; D008991:Monitoring, Physiologic / Q000662:veterinary; D058996:Quality Improvement