Reduction in intra-operative hypothermia in the burn patient population

Abstract

Introduction: Hypothermia can result in deleterious physiologic consequences, especially in burn patients, which are at higher risk due to loss of skin. Intra-and post-operative hypothermia (<36C) was identified as an audit filter for our Burn Center’s Quality Assurance Program. Methods: Data on burn patients were documented over 12 months to determine the incidence of hypothermia. Utilizing a root cause analysis, several areas for improvement were identified. Interventions were planned after reviewing evidenced-based research and “best practices” in regards to prevention of hypothermia. At the end of 12 months these interventions were initiated and included; reduction in variation of delivery of care through education and written Standards of Practice, and resource and environmental enhancement. Data was then collected over the next 12 months on hypothermia in all burn patients. Results: Data gathered for the 12 months prior to the intervention revealed a 47-75% incidence of intra-operative hypothermia (<36C). The first 3 months after the intervention showed a decrease of intra-operative hypothermia down to 1%. The next 9 months revealed the intra-operative hypothermia incidence to be 17-25%. There was an overall decrease in intra-operative hypothermia by 46%, after the interventions. Conclusion: Hypothermia in the burn patient is an important audit filter to monitor for quality of care because complications from hypothermia can have severe outcomes. Hypothermia prevention is an interdisciplinary issue and involves resources, standards of practice, and education. Utilizing a root cause analysis and gathering evidenced-based “best practices” for hypothermia prevention in burn patients were essential elements to reduction in hypothermia.