Reducing the Incidence of Hypothermia in Very Low Birth Weight Premature Newborns
張詩珮(Shih-Pei Chang)；蕭君瑋(Jiun-Woei Shiau)；曹伯年(Po-NienTsao)；鄭之勛(Jih-Shuin Jerng)；黃筱芳(Hsiao-Fang Huang)；張壁蘭(Pi-Lan Chang)；范圭玲(Guei-Ling Fann)；陳玉蓮(Yu-Lien Chen)
低體重早產兒低體溫發生率 ； 離開產房前低體溫發生率 ； 入住加護病房一小時內低體溫發生率 ； hypothermia ； very low birth weight newborns ； team resource management
|Volume or Term/Year and Month of Publication||
23卷4期（2019 / 07 / 25）
488 - 500
Hypothermia of very low birth weight (VLBW) preterm babies is associated with increased morbidity and mortality. Maintenance and stabilization of adequate body temperature are vital in this patient population. In this program, we aimed to reduce the incidence of hypothermia in VLBW preterm babies. Investigations showed that the major reasons of the high incidence of hypothermia in this institution included a low-temperature environment of the delivery room, unclear roles, and responsibilities among medical team members, unfamiliarity with the process of preventing hypothermia, insufficient education training and advocacy, and lack of standardized procedure to prevent hypothermia. Improvement strategies included maintenance of higher temperatures surrounding the infant and the transportation route, the provision of Team Resources Management (TRM) training with teaching video, establishment and implementation of a process checklist and prepared kit materials, ongoing education and training, establishment of standardized operation procedures according to current clinical situation, and intensified auditing of the clinical care process of the nurses. The results showed that the incidence of hypothermia before the neonate was leaving the delivery room has improved from 58.8% to 41.7% after the starting of improvement and then even lowered to 5.9% during the post-implementation period. The incidence of hypothermia in the first hour after admission to the neonatal intensive care unit was reduced from 83.3% to 41.7% during improvement and was 5.9% during the post-implementation period. We conclude that the implementation of these strategies in this program reduced the incidence of hypothermia in VLBW newborns effectively and improved the quality of care.