Cool babies, not so cool....

Aims

• To assess the incidence of hypothermia in newborns in our institution
• To develop a care bundle to reduce the incidence of hypothermia

Methods

This is a prospective audit of babies born over an eight week period (October-December 2016). A Plan-Do-Study-Act cycle was used. Prior to commencement, staff were educated on the mechanisms of reducing heat loss in the newborn. A quality improvement care bundle was developed and used to collect data. Data was reviewed and analysed on a weekly basis and improvement steps were implemented. Babies born in the labour ward during a one-week period of the study were used as control.

Results

There were 200 babies born during the study period; 166 (83%) of these were included in the study (10% were preterm). 18 infants in the study had hypothermia on admission to the postnatal ward. In the hypothermia group, a third of these were preterm; median gestational age was 36 weeks. The median birth weight was 2.79kg (range 1.26kg-4.12kg). The average room temperature recorded was lower in one theatre being 22.5° compared to another theatre (24.9°). Increasing the temperature in theatre to the optimal level of 23-25° reduced the incidence of hypothermia. 3 babies (17%) were hypothermic prior to leaving theatre. The average room temperature recorded in the labour ward was 24.8°. Only two babies born on the labour ward during the one week audit period had hypothermia on admission to the postnatal ward.

Conclusions

Eleven percent of babies born in the lower temperature environment had hypothermia on admission to postnatal ward, compared to 3% of babies born in the higher temperature environment

Recommendations:

1. Continued education of staff and implementation of care bundle
2. Ensuring delivery environmental temperature is set between 23-25°degrees
3. Transport incubator to be used when transferring preterm infants/low birth weight infants from delivery to NICU