EBPI: Nurse Led Change to Insure Normothermia in the Operating Room

            During routine monitoring, the quality department of our hospital, the Northern Westchester Hospital identified a number of colorectal patients with postoperative hypothermia.  The Surgical Care Improvement Project (SCIP) is a quality partnership of professional organizations including the Joint Commission and others.  One of SCIP’s core measures in 2009 was: “Colorectal patients with immediate postoperative normothermia.”  Investigation of unplanned perioperative hypothermia was delegated to the Evidence Based Practice (EBP)/Nursing Research Council. Thus the purpose of this project was to determine if maintaining ambient operating room temperatures from 68-72^oF until the time out versus routine care maintains post-operative normothermia in colorectal patients.

             We used the EBPI model developed by Levin and colleagues (2010) as our method to improve practice. A systematic review of the evidence demonstrated that unintentional perioperative hypothermia causes serious postoperative complications. Our internal data demonstrated that all of our hypothermic colorectal patients had one thing in common. Their surgery was performed in a cold operating room.  High level evidence also revealed that “Ambient room temperature remains the primary interoperative variable influencing whether patients will become hypothermic” (Burns, 2009, p. 169). We performed a small test of change by raising the ambient operating room temperature to 68 to 72^oF until the time out procedure.  As a result we increased the percent of patients who were normothermic after surgery from 70% to 100% in a three month period. An OR competency and policy was developed to implement a change in practice.