Improving the recognition and management of inadvertent perioperative hypothermia

Background: Inadvertent perioperative hypothermia (IPH) is a common consequence of anaesthesia, defined as core body temperature <36.0°C.1 Adverse effects include surgical site infection, coagulopathy, pain, altered drug metabolism, and adverse cardiac events.1 Preventing IPH vital part the enhanced recovery after surgery programme (ERAS).2 NICE clinical guideline (CG65) provides recommendations for avoiding IPH.3 Lancashire Teaching Hospitals falls below regional peers with regards to measuring recording within an hour before incision elective hip knee replacements. This quality improvement (QI) project aims improve recognition management IPH. Methods: Four QI cycles were carried out between 3 August 2021 1 December 2022, each including 20 patients undergoing hip, knee, shoulder A retrospective case note review was each, proforma based closely on CG65. methodology used initial interventions presentation anaesthetic consultants at departmental audit meeting, regular meetings theatre manager, creation display educational poster in all theatres. Further changes included email being sent operating department practitioners reinforce importance measurement room trial using forced air warming device (FAWD) arthroplasty over month. Results: At baseline it found that pre-induction inconsistently recorded WHO checklist, 0% having chart. Some 25% received FAWD 15% had <36.0°C arrival recovery. There no intraoperative By end period there increase chart from 0/20 7/20 patients. Use increased 5/20 11/20 (Fig. 3). Conclusion: Although positive change has been achieved, further documentation induction, use FAWD. The prevalence remained stable 10% 20% despite improvements, therefore additional elements care could also be addressed. Future steps involve ongoing team feedback addressing compliance fluid warming. 1.Riley C, Andrzejowski J. BJA Educ 2018; 18: 2272.Bernard H. Br J Nurs 2013; 22: 319–253.NICE. Perioperative (inadvertent): inadvertent adults, Clinical Guideline 65, 2008. Available www.nice.org.uk/guidance/cg65 (accessed 20/03/23)