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The effect of perioperative body temperature management on unplanned hypothermia

Hsiao Wen Tsai

Statement of the Problem: Surgical site infections (SSI) are significantly associated with longer inpatient length of stay, higher medical expense and poor life quality. It is estimated that 40~60% of SSI is preventable. Unplanned hypothermia could predispose to SSI and might occur in 50% of patients undergoing anesthesia in the operation room. World Health Organization (WHO) has suggested that maintaining peri-operative normothermia above 36% is effective in reducing SSI. The purpose of this study is to describe the experience of team work from surgical ward, operation room and anesthesia department to improve body temperature management for inpatients undergoing surgery. Methodology & Theoretical Orientation: An inter-departmental improvement program was initiated to use warming equipment, establish hypothermia guideline and hand-over system. The guideline kept perioperative body temperatures with various warming equipment according to body temperature. Findings: Peri-operative body temperature monitoring and complete hand-over reached 100%. Unplanned hypothermia decreased from 38.2% (335/884) to 29.2% (121/418) during transfer from ward to operation room and decreased from 27% to 1.5% during transfer from operation room to the post-anesthesia care unit. Conclusion & Significance: An inter-departmental body temperature management protocol reduced perioperative hypothermia. A team work between surgery ward, operation room and anesthesia department provided continuous body temperature monitoring and suitable warming guideline thus ensured the perioperative care quality.