Occlusive Bags to Prevent Hypothermia in Premature Infants: A Quality Improvement Initiative

Godfrey, Kathleen

Monday, 31 October 2011

Kathleen Godfrey, MSN, NNP-BC, CPNP
Elizabeth A. Schlenk, PhD, RN
School of Nursing, University of Pittsburgh, Pittsburgh, PA

Learning Objective 1: The learner will be able to discuss the research evidence supporting a protocol to change clinical practice to prevent hypothermia in premature infants.

Learning Objective 2: The learner will be able to describe the clinical protocol for applying occlusive bags to prevent hypothermia in premature infants immediately after delivery.

Practice Problem: Premature infants are at increased risk for hypothermia at birth, and prevention is critically important to their long-term outcomes and survival, as well as lower health care costs. The aims of this quality improvement initiative are: to improve the initial body temperatures of infants born at less than 28 weeks gestation by placing them in an occlusive bag from the neck down, initially after delivery; to implement and evaluate the clinical protocol; and to establish a clinical practice change for the thermal management of extremely low birth weight infants during the immediate stabilization and resuscitation period after birth.

Evidence Used and Synthesized: A literature search was conducted to support this proposed change in clinical practice. Pub Med, EMBASE, and CINAHL databases were searched, and seven relevant articles were identified that documented sufficient data to support the proposed change in practice. The quality of the overall evidence is Level I, based on modified Agency for Healthcare Research and Quality criteria.

Implementation Strategy: A one-group post-test only quasi-experimental design with a historical control group will be recruited. The historical control and treatment groups will consist of approximately 50 eligible preterm infants born at less than 28 weeks gestation. After a 6-month retrospective record review is performed to collect data for the control group, a 6-month prospective phase will be conducted in which infants in the treatment group will be placed in an occlusive bag from the neck down immediately after birth and nursery admission temperatures will be recorded. A staff satisfaction survey will be distributed after the completion of the project.

Evaluation: Mean nursery admission rectal temperatures of the two groups will be compared, controlling for delivery room site and time from birth to nursery admission. Staff satisfaction will be described.

Outcomes: The project is currently underway with results pending.

See more of: Poster Session II
See more of: Oral Paper & Poster: Evidence-Based Practice Contest