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G27(P) Quality improvement project for neonatalthermoregulation at birth
  1. S Nallagonda1,
  2. T Banerjee1,
  3. A Deorukhkar2
  1. 1Tertiary Neonatal Intensive Care Unit, Luton and Dunstable University Teaching Hospital NHS Foundation Trust, Luton, UK
  2. 2Tertiary Neonatal Intensive Care Unit, Nottingham University Hospitals NHS Trust, Nottingham, UK

Abstract

Aims Audit of impact of thermoregulation bundle and staff education on neonatal admission temperatures.

Methods Importance of thermoregulation around the time of birth till admission onto the neonatal unit cannot be underestimated. Temperature instability and in particular admission temperatures<36.5°C are associated with increased morbidity and mortality1. We have local as well as national guidelines for optimal thermoregulation in delivery suite and during transport to neonatal unit. On our unit, the staff training was undertaken in the form of one to one educational sessions. Wall posters were also put up to increase awareness among staff members. Simple ‘thermoregulation sticker’ were used to document delivery room temperature, baby’s temperature at birth, while on the delivery suite and on admission to Neonatal unit. Prospective audit was then undertaken collecting data over a period of three months from May 2016 to July 2016. Data was collected from Badgernet admissions.

Results Total 22 neonates of <32 weeks gestation, were born in our hospital during the audit period of May 2016 – July 2016. Out of these, only three babies (13.6%) had admission temperature below 36.5°C. as compared with 2015, where 28% of babies in this gestation group were identified to be hypothermic on admission. Our year 2015 data was comparable with the national average from NNAP data.

Conclusion Increasing awareness and staff education has had significantly positive impact in improving existing practice of thermoregulation in babies admitted to neonatal unit from delivery suite. This was observed more robustly in group of babies born with gestational age of <32 weeks.

Recommendations We recommend monitoring the temperature of newborn in the delivery suite and increasing awareness of the staff about taking additional measures to maintain normothermia during the transfer from delivery suite to neonatal unit. We also recommended inclusion of the stickers of thermoregulation in to the admission notes as a routine practice and importance of regular staff education to increase awareness of thermoregulation in the newborn babies.

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