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Advocate Christ Medical Center

Presentation Notes

Research poster presentation at Elevating Nursing Excellence: Purpose, Profession, Passion; Advocate Health Midwest Region Nursing Research & Professional Development Conference 2024; November 13, 2024; virtual.

Abstract

Background:

Unintended perioperative hypothermia (UPH) increases complications including surgical site infections (SSIs), which reduce patient outcomes and increase personal and financial costs.

Hypothesis:

Adding a thermo-reflective blanket on top of warming standard of care (WSOC) will reduce UPH, SSI, post-op length of stay (POLOS), and financial costs.

Methods:

We used a prospective, single-blinded randomized controlled trial (RCT). The control group received warming standard of care (WSOC); the intervention group received thermo-reflective blanket(s) in addition to the WSOC. The WSOC includes passive insulation of warmed cotton blankets and thermo-reflective head coverings with active warming of forced air. Odds ratios, student’s t-test, and chi-squared analyses described demographics and analyzed blanket superiority criteria.

Findings:

Adding thermo-reflective blankets did not reduce risks for hypothermia (OR=1.35, 95%CI=3.0-0.60, p=0.235) or SSIs (OR=0.393, 95%CI=1.5-0.10, p=0.094), but reduced time under anesthesia by 1.1 hours (p=0.001), POLOS by 1.56 days (p=0.061), and financial cost (p=0.021). Adding the blanket also increased the mean temperature by 1.1ºC (p=0.006).

Conclusions:

This study suggests adding thermo-reflective blanket(s) to standard warming is superior to not having it. It is inexpensive, simple, effective method for increasing patient temperature, reducing time under anesthesia, and reducing POLOS and financial costs. Although marginal, a 1.1 ˚C increase could be clinically important to reduce complications and increase patient comfort. Perioperative nurses should re-evaluate their patient temperature management protocols and practices to determine if adding the blanket is feasible since it is within their scope of practice.

In addition to adding the blanket, this study suggests improving perioperative team education and communication about patient temperature risk factors, complications, and management guidelines and protocols. Including the perioperative team rather than isolating patient temperature to the sole responsibility of the anesthesiologist is an evidence-based way perioperative nurses can increase patient temperatures, improve outcomes, and increase team satisfaction.

Document Type

Poster

Publication Date

11-13-2024


 

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Nov 13th, 12:00 AM

Investigating nursing impact to surgical outcomes by adding a thermo-reflective blanket to warming protocol: A randomized control trial

Background:

Unintended perioperative hypothermia (UPH) increases complications including surgical site infections (SSIs), which reduce patient outcomes and increase personal and financial costs.

Hypothesis:

Adding a thermo-reflective blanket on top of warming standard of care (WSOC) will reduce UPH, SSI, post-op length of stay (POLOS), and financial costs.

Methods:

We used a prospective, single-blinded randomized controlled trial (RCT). The control group received warming standard of care (WSOC); the intervention group received thermo-reflective blanket(s) in addition to the WSOC. The WSOC includes passive insulation of warmed cotton blankets and thermo-reflective head coverings with active warming of forced air. Odds ratios, student’s t-test, and chi-squared analyses described demographics and analyzed blanket superiority criteria.

Findings:

Adding thermo-reflective blankets did not reduce risks for hypothermia (OR=1.35, 95%CI=3.0-0.60, p=0.235) or SSIs (OR=0.393, 95%CI=1.5-0.10, p=0.094), but reduced time under anesthesia by 1.1 hours (p=0.001), POLOS by 1.56 days (p=0.061), and financial cost (p=0.021). Adding the blanket also increased the mean temperature by 1.1ºC (p=0.006).

Conclusions:

This study suggests adding thermo-reflective blanket(s) to standard warming is superior to not having it. It is inexpensive, simple, effective method for increasing patient temperature, reducing time under anesthesia, and reducing POLOS and financial costs. Although marginal, a 1.1 ˚C increase could be clinically important to reduce complications and increase patient comfort. Perioperative nurses should re-evaluate their patient temperature management protocols and practices to determine if adding the blanket is feasible since it is within their scope of practice.

In addition to adding the blanket, this study suggests improving perioperative team education and communication about patient temperature risk factors, complications, and management guidelines and protocols. Including the perioperative team rather than isolating patient temperature to the sole responsibility of the anesthesiologist is an evidence-based way perioperative nurses can increase patient temperatures, improve outcomes, and increase team satisfaction.

 

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