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Oden TN, Celikturk Doruker N, Demir Korkmaz F. Perioperative Health Care Professionals' Knowledge of Evidence-Based Inadvertent Perioperative Hypothermia Management. J Perianesth Nurs 2024:S1089-9472(23)01097-3. [PMID: 38520469 DOI: 10.1016/j.jopan.2023.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 12/07/2023] [Accepted: 12/09/2023] [Indexed: 03/25/2024]
Abstract
PURPOSE To evaluate the perioperative health care professionals' knowledge of evidence-based inadvertent perioperative hypothermia management. DESIGN A descriptive, cross-sectional study. METHODS The research sample consisted of 219 perioperative nurses and anesthesia technicians working in the university hospital and participating in perioperative care. Data were collected by the researchers using a questionnaire that included descriptive characteristics of health care professionals and inadvertent perioperative hypothermia management between March and April 2021. Descriptive statistics, Shapiro-Wilk normality, Kruskal Wallis, Mann Whitney U, and Spearman correlation test were used to analyze the data. FINDINGS In this study, only 29.2% of the health care professionals knew that the threshold value for inadvertent perioperative hypothermia was <36 °C. The mean knowledge score of health care professionals on the management of inadvertent perioperative hypothermia was 13.78 ± 3.47. The knowledge score of 79.5% of health care professionals was moderate level. A significant correlation was determined between inadvertent perioperative hypothermia management knowledge score and education status (P = .032), task (P < .001), and mean years in the profession (P = .02). CONCLUSIONS The knowledge of the health care professionals working in the perioperative process about evidence-based practices related to inadvertent perioperative hypothermia management was determined to be moderate. We recommend increasing the level of knowledge of health care professionals by providing education on guidelines regarding inadvertent perioperative hypothermia management.
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Affiliation(s)
- Tugba N Oden
- Department of Organ Transplantation Center, Ege University Hospital, Izmir, Turkey.
| | | | - Fatma Demir Korkmaz
- Department of Surgical Nursing, Ege University Faculty of Nursing, Izmir, Turkey
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Bozkurt Z, Şahin Akboğa Ö. The Relationship of Perioperative Inadvertent Hypothermia with Anxiety and Comfort. Ther Hypothermia Temp Manag 2024. [PMID: 38394137 DOI: 10.1089/ther.2023.0089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024] Open
Abstract
The study aimed to investigate the relationship of perioperative inadvertent hypothermia with anxiety and thermal and general comfort in surgical patients. Inadvertent perioperative hypothermia occurs after surgery and affects many patient outcomes. However, the relationship between hypothermia and anxiety has been given little attention. The research is of descriptive type. A total of 117 surgical patients who met the inclusion criteria were sampled and divided into two groups: hypothermic (n = 54) and normothermic (n = 63). Patients undergoing surgery were monitored for body temperature, systolic and diastolic blood pressure, heart rate, pain intensity, anxiety (Numeric Rating Scale [NRS] and State Anxiety Scale [SAI]), and comfort (Perianesthesia Comfort Questionnaire) levels. The groups were similar in terms of descriptive characteristics (p > 0.05). Among the patients undergoing surgical intervention, 46.1% were hypothermic. Compared with the normothermic group, the hypothermic group had significantly lower body temperature until the second postoperative hour, lower thermal comfort score until the third postoperative hour, and higher heart rate and anxiety (NRS) score until the first postoperative day. Furthermore, there was a significant difference between the groups in terms of pain intensity up to the first 30 minutes after surgery (p < 0.05). Moreover, there was no significant difference between the groups in terms of pre and postoperative day one anxiety (SAI) and Periantesthesia Comfort Scale mean scores (p > 0.05). The study findings showed that hypothermia affected thermal comfort up to the first 3 hours after surgery, pain intensity up to the first 30 minutes, and heart rate and anxiety (NRS) levels up to the first day.
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Affiliation(s)
- Zehra Bozkurt
- Department of Nursing, Faculty of Health Sciences, University of Yozgat Bozok, Yozgat, Turkey
| | - Özlem Şahin Akboğa
- Department of Nursing, Faculty of Health Sciences, University of Yozgat Bozok, Yozgat, Turkey
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Durmaz M, Yüksel S, Kural ŞK. Inadvertent Hypothermia in the Perspective of Operating Room Nurses: A Phenomenological Qualitative Study. J Perianesth Nurs 2024:S1089-9472(23)01059-6. [PMID: 38300196 DOI: 10.1016/j.jopan.2023.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 11/13/2023] [Accepted: 11/13/2023] [Indexed: 02/02/2024]
Abstract
PURPOSE The aim of the study was to reveal the awareness and perceptions of operating room nurses concerning inadvertent hypothermia, as well as their experiences and recommendations for its prevention. DESIGN The study employed a phenomenological qualitative approach. METHODS This study was conducted with 17 nurses working in the operating room of a university hospital in Konya, Turkey. Data were collected face to face between 15 August and 30 September 2022 using the in-depth individual interview method. The data were subjected to inductive content analysis. Written permission was obtained from the hospital, the ethics committee, and the participants to conduct the study. FINDINGS The mean age of the nurses was 28.4 years and the majority were female. The nurses were graduates of a four-year health vocational high school, a two-year nursing associate degree program, or a four-year nursing bachelors' degree program. Their operating room experience ranged from 1 to 22 years. All the nurses were aware of inadvertent hypothermia, and all but one encountered hypothermia and applied preventive measures. The data analysis revealed 263 codes, 12 categories, and 4 themes on the awareness and perceptions of operating room nurses about inadvertent hypothermia and their experiences and recommendations for its prevention. CONCLUSIONS The findings showed that the majority of the participants were aware of inadvertent hypothermia and its risk factors, and frequently encountered inadvertent hypothermia despite implementing preventive measures.
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Affiliation(s)
- Melike Durmaz
- Department of Surgical Nursing, Faculty of Nursing, Selçuk University, Konya, Turkey
| | - Serpil Yüksel
- Department of Surgical Nursing, Division of Nursing, Faculty of Nursing, Necmettin Erbakan University, Konya, Turkey.
| | - Şerife K Kural
- Department of Nursing, Faculty of Health Sciences, Alanya Alaaddin Keykubat University, Alanya, Turkey
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Woretaw AW, Yimer Mekonnen B, Tsegaye N, Dellie E. Knowledge and practice of nurses with respect to perioperative hypothermia prevention in the Northwest Amhara Regional State Referral Hospitals, Ethiopia: a cross-sectional study. BMJ Open 2023; 13:e068131. [PMID: 38097235 PMCID: PMC10729143 DOI: 10.1136/bmjopen-2022-068131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 11/30/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVES It has been reported that maintaining a normal body temperature among surgical patients can reduce the length of hospitalisation by up to 40%, decrease the risk of surgical site infection by 64% and reduce mortality by fourfold. Nurses are primarily responsible for preventing the occurrence of hypothermia among surgical patients. This study assessed nurses' knowledge and practices with respect to perioperative hypothermia prevention in Northwest Ethiopia, and investigated the factors associated with good knowledge and practice. DESIGN Cross-sectional study. SETTING Northwest Amhara Regional State Referral Hospitals, Northwest Ethiopia, 25 March-20 May 2021. PARTICIPANTS 413 nurses working in the perioperative units of five referral hospitals. OUTCOME MEASURES Perioperative hypothermia prevention knowledge and practice among nurses. RESULTS Nearly three-fifths (59.1%; 95% CI: 54.7% to 63.7%) of respondents had good knowledge and about half (50.4%; 95% CI: 45.5% to 55.0%) had good practice with respect to perioperative hypothermia prevention. Factors associated with nurses' knowledge of prevention of perioperative hypothermia included male sex (adjusted OR (AOR): 1.61, 95% CI: 1.02 to 2.53), having a bachelor's degree (AOR: 2.50, 95% CI: 1.25 to 5.00), having a master's degree (AOR: 4.39, 95% CI: 1.45 to 13.20) and training participation (AOR: 3.68, 95% CI: 2.14 to 6.33). Factors associated with nurses' practice of prevention of perioperative hypothermia included working in recovery (AOR: 2.87, 95% CI: 1.08 to 7.58) and intensive care units (AOR: 2.39, 95% CI: 1.09 to 5.22), training participation (AOR: 2.64, 95% CI: 1.53 to 4.57), being satisfied with their job (AOR: 2.15, 95% CI: 1.34 to 3.43) and having good knowledge (AOR: 2.64, 95% CI: 1.63 to 4.27). CONCLUSION Nurses' knowledge and practice of the prevention of perioperative hypothermia were inadequate. Hospital managers need to design and strengthen training programmes and work to enhance job satisfaction.
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Affiliation(s)
- Ashenafi Worku Woretaw
- Department of Surgical Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Bezenaw Yimer Mekonnen
- Department of Emergency and Critical Care Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Netsanet Tsegaye
- Department of Emergency and Critical Care Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Endalkachew Dellie
- Departmeny of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Şahin Akboğa Ö, Gürkan A. Effects of Active Heating Methods on Body Temperature, Shivering, Thermal Comfort, Pain, Nausea and Vomiting During General Anesthesia: A Randomized Controlled Trial. Ther Hypothermia Temp Manag 2023. [PMID: 38011688 DOI: 10.1089/ther.2023.0049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023] Open
Abstract
To investigate the effect of forced-air warming and heated intravenous (IV) and irrigation fluids alone and in combination on body temperature, shivering, thermal comfort, pain, nausea and vomiting in adult patients undergoing surgery under general anesthesia in a prospective, four-group, randomized controlled trial. After induction of anesthesia, 120 patients were divided into the following groups: patients warmed with forced-air warming (n = 30), patients receiving warmed IV and irrigation fluid (n = 30), patients receiving warmed IV and irrigation fluid with forced-air warming (n = 30), and the control group without any intervention (n = 30). Body temperature, shivering, thermal comfort, pain, nausea and vomiting were monitored in the first 24 hours after surgery. The general characteristics of the groups, mean body temperature, length of stay, ambient temperature, and duration of surgery in the preoperative waiting unit were similar (p > 0.05). Compared with the other groups, patients in the control group had a significant decrease in body temperature from the 30th minute during surgery (p < 0.001), lower body temperature in the first 2 hours and thermal comfort in the first three hours after surgery (p < 0.01), and higher shivering levels in the first hour after surgery (p < 0.01). There was no significant difference between the groups in terms of postoperative pain, nausea and vomiting (p > 0.05). The study findings showed that normothermia was maintained in all three intervention groups during the surgery and in the first 24 hours after surgery. Moreover, postoperative thermal comfort increased and shivering levels decreased compared with the control group, but pain, nausea and vomiting levels were not affected. The study was registered on ClinicalTrials.gov (NCT04907617).
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Affiliation(s)
| | - Aysel Gürkan
- Faculty of Health Sciences, University of Marmara, Istanbul, Turkey
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Sahin Akboga O, Dikmen Aydin Y. Barriers and Solutions in Implementing Evidence-Based Recommendations to Prevent Intraoperative Inadvertent Hypothermia: A Qualitative Study. Ther Hypothermia Temp Manag 2023. [PMID: 37976212 DOI: 10.1089/ther.2023.0052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
In this study, it was aimed to understand the barriers and solutions for operating room (OR) nurses and anesthesiologists to implement evidence-based recommendations to prevent intraoperative inadvertent hypothermia (IIH). A qualitative, inductive, and descriptive study was conducted. This qualitative interview study was conducted face-to-face with 19 participants working in OR units between February and March 2023. The interviews were analyzed using qualitative content analysis. The COREQ checklist was followed. Two main themes and five sub-themes were identified as a result of content analysis. According to the participants, barriers to IIH prevention interventions are caused by individual and organizational inefficiencies and personal opinions, and the main solution is education. Participants reported many factors that hinder IIH prevention practices. The individual characteristics of OR staff and the opinions and behavior of the institution are very important for IIH prevention.
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Affiliation(s)
- Ozlem Sahin Akboga
- Department of Nursing, Faculty of Health Sciences, University of Yozgat Bozok, Yozgat, Turkey
| | - Yesım Dikmen Aydin
- Department of Nursing, Faculty of Health Sciences, University of Marmara, Istanbul, Turkey
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Accidental Hypothermia and Related Risk Factors among Trauma Patients Admitted to the Emergency Department. PREVENTIVE CARE IN NURSING AND MIDWIFERY JOURNAL 2021. [DOI: 10.52547/pcnm.11.1.63] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Ralph N, Gow J, Conway A, Duff J, Edward KL, Alexander K, Bräuer A. Costs of inadvertent perioperative hypothermia in Australia: A cost-of-illness study. Collegian 2020. [DOI: 10.1016/j.colegn.2019.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Lupo BL, Collins SB, Hewer I, Hooper VD. Comparing Forced-Air to Resistive-Polymer Warming for Perioperative Temperature Management: A Retrospective Study. J Perianesth Nurs 2019; 35:178-184. [PMID: 31859207 DOI: 10.1016/j.jopan.2019.08.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 08/06/2019] [Accepted: 08/19/2019] [Indexed: 11/18/2022]
Abstract
PURPOSE Compare perioperative temperature management between forced-air warming (FAW) and resistive-polymer heating blankets (RHBs). DESIGN A retrospective, quasi-experimental study. METHODS Retrospective data analysis of nonspine orthopedic cases (N = 426) over a one-year period including FAW (n = 119) and RHBs (n = 307). FINDINGS FAW was associated with a significantly higher final intraoperative temperature (P = .001, d = 0.46) than the RHB. The incidence of hypothermia was not found to be significantly different at the end (P = .102) or anytime throughout surgery (P = .270). Of all patients who started hypothermic, the FAW group had a lower incidence of hypothermia at the end of surgery (P = .023). CONCLUSIONS FAW was associated with higher final temperatures and a greater number of normothermic patients than RHBs. However, no causal relationship between a warming device and hypothermia incidence should be assumed.
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Affiliation(s)
| | | | - Ian Hewer
- Western Carolina University, School of Nursing, Asheville, NC
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Watanabe K, Tsubouchi T, Yamada T, Hinoi E, Miyawaki I. Telemetered common marmosets is useful for the assessment of electrocardiogram parameters changes induced by multiple cardiac ion channel inhibitors. J Toxicol Sci 2019; 44:441-457. [PMID: 31270301 DOI: 10.2131/jts.44.441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
The objective of this study is to assess the response of telemetered common marmosets to multiple cardiac ion channel inhibitors and to clarify the usefulness of this animal model in evaluating the effects of drug candidates on electrocardiogram (ECG). Six multiple cardiac ion channel inhibitors (sotalol, astemizole, flecainide, quinidine, verapamil and terfenadine) were orally administered to telemetered common marmosets and changes in QTc, PR interval and QRS duration were evaluated. Drugs plasma levels were determined to compare the sensitivity in common marmosets to that in humans. QTc prolongation was observed in the marmosets dosed with sotalol, astemizole, flecainide, quinidine, verapamil and terfenadine. PR prolongation was noted after flecainide and verapamil administration, and QRS widening occurred following treatment with flecainide and quinidine. Drugs plasma levels associated with ECG changes in marmosets were similar to those in humans, except for verapamil-induced QTc prolongation. Verapamil-induced change is suggested due to body temperature decrease. These results indicate that telemetered common marmoset is a useful animal for evaluation of the ECG effects of multiple cardiac ion channel inhibitors and the influence of body temperature change should be considered in the assessment.
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Affiliation(s)
- Kenta Watanabe
- Preclinical Research Unit, Sumitomo Dainippon Pharma Co., Ltd.,Laboratory of Molecular Pharmacology, Division of Pharmaceutical Sciences, Kanazawa University Graduate School
| | | | - Toru Yamada
- Preclinical Research Unit, Sumitomo Dainippon Pharma Co., Ltd
| | - Eiichi Hinoi
- Laboratory of Molecular Pharmacology, Division of Pharmaceutical Sciences, Kanazawa University Graduate School
| | - Izuru Miyawaki
- Preclinical Research Unit, Sumitomo Dainippon Pharma Co., Ltd
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Munday J, Delaforce A, Forbes G, Keogh S. Barriers and enablers to the implementation of perioperative hypothermia prevention practices from the perspectives of the multidisciplinary team: a qualitative study using the Theoretical Domains Framework. J Multidiscip Healthc 2019; 12:395-417. [PMID: 31239694 PMCID: PMC6551587 DOI: 10.2147/jmdh.s209687] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 04/05/2019] [Indexed: 12/29/2022] Open
Abstract
Purpose: Inadvertent perioperative hypothermia is a significant problem for surgical patients globally, and is associated with many detrimental side-effects. Despite the availability of rigorously developed international evidence-based guidelines for prevention, a high incidence of this complication persists. This qualitative study aims to identify and examine the domains which act as barriers and enablers to perioperative hypothermia prevention practices, from the perspectives of the key healthcare professionals involved with perioperative temperature management. Methods: A qualitative study employing semi-structured interviews was utilized. A purposive sample of key stakeholders involved in perioperative temperature management, including perioperative nurses, anesthetists, surgeons, and perioperative managers, were recruited via email. The interview guide was developed in reference to the Theoretical Domains Framework. All interviews were recorded, de-identified, transcribed, and coded. Belief statements were generated within each domain, and a frequency score generated for each belief. Finally, the domains were mapped to the COM-B model of the Behavior Change Wheel to develop recommendations for future interventions. Results: Twelve participants were included including eight nurses, two surgeons, and two anesthetists. Eleven key theoretical domains that influence the uptake of perioperative hypothermia practices were identified: knowledge; skills; social/professional role and identity; beliefs about capabilities; optimism; beliefs about consequences; reinforcement; goals; memory, attention, and decision processes; environmental context and resources; social influence. Suggested intervention strategies include training, reminder systems, audit, and feedback, organizational support to resolve lack of control of ambient temperature, as well as provision of accurate temperature measurement devices. Conclusion: Future interventions to address the key behavioral domains and improve perioperative hypothermia prevention need to be evaluated in the context of feasibility, effectiveness, safety, acceptability, and cost by the target users. All suggested intervention strategies need to take a team-based, multi-modal approach, as this is most likely to facilitate improvements in perioperative hypothermia prevention.
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Affiliation(s)
- Judy Munday
- School of Nursing and Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia.,Department of Health and Nursing Science, University of Agder, Grimstad, Norway
| | - Alana Delaforce
- School of Nursing and Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia.,Clinical Governance Unit, Mater Health, South Brisbane, QLD 4101, Australia
| | - Gillian Forbes
- Department of Clinical, Educational and Health Psychology, UCL Centre for Behaviour Change, London WC1E 6BT, UK
| | - Samantha Keogh
- School of Nursing and Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia
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Pourrezaei S, Dinmohammadi M, Jafari rouhi A. The Effect of Thermal Care Workshop on EMS Staff Readiness in managing Accidental Hypothermia in Trauma Patients. PREVENTIVE CARE IN NURSING AND MIDWIFERY JOURNAL 2018. [DOI: 10.29252/pcnm.8.2.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Giuliano KK, Hendricks J. Inadvertent Perioperative Hypothermia: Current Nursing Knowledge. AORN J 2017; 105:453-463. [PMID: 28454611 DOI: 10.1016/j.aorn.2017.03.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Revised: 07/14/2016] [Accepted: 03/07/2017] [Indexed: 11/26/2022]
Abstract
Inadvertent perioperative hypothermia is estimated to affect 70% of surgical patients and is associated with adverse clinical outcomes, lengthened hospital stays, and increased costs. To better understand the current level of nursing knowledge on this subject since the release of the "Guideline for prevention of unplanned patient hypothermia," we conducted an e-mail survey of AORN members. The overall response rate was 6.5% (N = 324), and most responding nurses overestimated or underestimated the lower and upper limits for normothermia. When asked about the most common complications associated with hypothermia, respondents identified shivering (68.2%), surgical site infections (65.4%), and cardiac events (61.7%); only 44.8% and 33.6% identified blood loss and pressure injuries, respectively. These results indicate a need for ongoing interventions to increase awareness and promote best practices to prevent and manage inadvertent perioperative hypothermia.
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Factors that influence effective perioperative temperature management by anesthesiologists: a qualitative study using the Theoretical Domains Framework. Can J Anaesth 2017; 64:581-596. [PMID: 28211002 DOI: 10.1007/s12630-017-0845-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 12/21/2016] [Accepted: 02/09/2017] [Indexed: 10/20/2022] Open
Abstract
PURPOSE Inadvertent perioperative hypothermia (IPH) is associated with a range of adverse outcomes. Safe and effective warming techniques exist to prevent IPH; however, IPH remains common. This study aimed to identify factors that anesthesiologists perceive may influence temperature management during the perioperative period. METHODS After Research Ethics Board approval, semi-structured interviews were conducted with staff anesthesiologists at a Canadian academic hospital. An interview guide based on the Theoretical Domains Framework (TDF) was used to capture 14 theoretical domains that may influence temperature management. The interview transcripts were coded using direct content analysis to generate specific beliefs and to identify relevant TDF domains perceived to influence temperature management behaviour. RESULTS Data saturation was achieved after 15 interviews. The following nine theoretical domains were identified as relevant to designing an intervention for practices in perioperative temperature management: knowledge, beliefs about capabilities, beliefs about consequences, reinforcement, memory/attention/decision-making, environmental context and resources, social/professional role/identity, social influences, and behavioural regulation. Potential target areas to improve temperature management practices include interventions that address information needs about individual temperature management behaviour as well as patient outcome (feedback), increasing awareness of possible temperature management strategies and guidelines, and a range of equipment and surgical team dynamics that influence temperature management. CONCLUSION This study identified several potential target areas for future interventions from nine of the TDF behavioural domains that anesthesiologists perceive to drive their temperature management practices. Future interventions that aim to close the evidence-practice gap in perioperative temperature management may include these targets.
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Beedle SE, Phillips A, Wiggins S, Struwe L. Preventing Unplanned Perioperative Hypothermia in Children. AORN J 2017; 105:170-183. [DOI: 10.1016/j.aorn.2016.12.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 05/05/2016] [Accepted: 12/02/2016] [Indexed: 11/26/2022]
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Gustafsson IL, Elmqvist C, From-Attebring M, Johansson I, Rask M. The Nurse Anesthetists' Adherence to Swedish National Recommendations to Maintain Normothermia in Patients During Surgery. J Perianesth Nurs 2016; 32:409-418. [PMID: 28938976 DOI: 10.1016/j.jopan.2016.03.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2015] [Revised: 02/25/2016] [Accepted: 03/06/2016] [Indexed: 12/01/2022]
Abstract
PURPOSE The aim of this study was to determine if nurse anesthetists (NAs) have access, knowledge, and adhere to recommended guidelines to maintain normal body temperature during the perioperative period. DESIGN A descriptive survey design. METHODS Questionnaires were sent to heads of the department (n = 56) and NAs in the operating departments in Sweden. FINDING The level of access to the recommendations is high, but only one third of the operating departments have included the recommendations in their own local guidelines. The NAs' adherence was low, between 5% and 67%, and their knowledge levels were 57% to 60%. CONCLUSIONS A high level of knowledge, access, and adherence are important for the organization of operating departments to prevent barriers against implementation of new recommendations or guidelines. There are needs for education about patients' heat loss due to redistribution and clear recommendations.
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Effect of Pre-warming on Reducing the Incidence of Inadvertent Peri-operative Hypothermia for Patients Undergoing General Anaesthesia: A Mini-review. ACTA ACUST UNITED AC 2013. [DOI: 10.1017/s1742645613000144] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjective:This mini-review aims to assess the effect pre-warming has on reducing the incidence of inadvertent peri-operative hypothermia for patients undergoing general anaesthesia.Method:A search of the MEDLINE and EMBASE databases, as well as hand-searching through the reference lists of key articles, was undertaken. Articles were included on the basis that the studies were randomised controlled trials, undertaken on patients who were undergoing surgery under general anaesthesia and were pre-warmed for 60 minutes using forced-air warming systems. This resulted in two articles being critically appraised and reviewed using guidelines based on those given in Greenhalgh and Donald (2000).Findings:The results for both of these studies showed that statistically significant differences were seen in core body temperature, with analysis of variance used to test for the significant differences between the sample means. The findings were also clinically significant, as a small drop in temperature as a result of anaesthesia and surgery can lead to IPH, and with pre-warming this can be avoided.Conclusion:The studies that were used in this review both reported that pre-warming patients for 60 minutes pre-operatively had both a statistically significant and clinically significant effect. This means that patients should receive a period of pre-warming before surgery in addition to being warmed peri-operatively, in order to reduce any drop in potential temperature that can lead to IPH.
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Duff J, Di Staso R, Cobbe KA, Draper N, Tan S, Halliday E, Middleton S, Lam L, Walker K. Preventing hypothermia in elective arthroscopic shoulder surgery patients: a protocol for a randomised controlled trial. BMC Surg 2012; 12:14. [PMID: 22817672 PMCID: PMC3411492 DOI: 10.1186/1471-2482-12-14] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Accepted: 07/20/2012] [Indexed: 11/10/2022] Open
Abstract
Background Patients having arthroscopic shoulder surgery frequently experience periods of inadvertent hypothermia. This common perioperative problem has been linked to adverse patient outcomes such as myocardial ischaemia, surgical site infection and coagulopathy. International perioperative guidelines recommend patient warming, using a forced air warming device, and the use of warmed intraoperative irrigation solutions for the prevention of hypothermia in at-risk patient groups. This trial will investigate the effect of these interventions on patients’ temperature, thermal comfort, and total recovery time. Method/Design The trial will employ a randomised 2 x 2 factorial design. Eligible patients will be stratified by anaesthetist and block randomised into one of four groups: Group one will receive preoperative warming with a forced air warming device; group two will receive warmed intraoperative irrigation solutions; group three will receive both preoperative warming and warmed intraoperative irrigation solutions; and group four will receive neither intervention. Participants in all four groups will receive active intraoperative warming with a forced air warming device. The primary outcome measures are postoperative temperature, thermal comfort, and total recovery time. Primary outcomes will undergo a two-way analysis of variance controlling for covariants such as operating room ambient temperature and volume of intraoperative irrigation solution. Discussion This trial is designed to confirm the effectiveness of these interventions at maintaining perioperative normothermia and to evaluate if this translates into improved patient outcomes. Australian New Zealand Clinical Trials Registry number ACTRN12610000591055
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Affiliation(s)
- Jed Duff
- St Vincent's Private Hospital, and Nursing Research Institute, St Vincent’s & Mater Health Sydney-Australian Catholic University, Victoria Street, Darlinghurst, NSW, 2010, Australia.
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Management of hypothermia: impact of lecture-based interactive workshops on training of pediatric nurses. Pediatr Emerg Care 2012; 28:455-9. [PMID: 22531187 DOI: 10.1097/pec.0b013e318253573d] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study aimed to determine the efficacy of interactive workshop on the management of hypothermia and its impact on pediatric nurses' training. This is a pretest-to-posttest quasi-experimental descriptive study. Thirty pediatric nurses attended an interactive lecture-based interactive workshop on the management of hypothermia. Participants had to accept an invitation to the presentation before the training event. They completed the lecture, and a multiple-choice question test before and after the lecture was given. There was a significant improvement in mean test scores after the lecture when compared with those before the lecture (mean [SD], 15.5 [1.3] vs 5.0 [1.7], P < 0.001). The information gained in this study will be valuable as a baseline for further research and help guide improvements in the management of hypothermia with the ultimate goal of enhancing safe and quality patient care.
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Cobbe KA, Di Staso R, Duff J, Walker K, Draper N. Preventing Inadvertent Hypothermia: Comparing Two Protocols for Preoperative Forced-Air Warming. J Perianesth Nurs 2012; 27:18-24. [DOI: 10.1016/j.jopan.2011.10.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Revised: 10/18/2011] [Accepted: 10/31/2011] [Indexed: 12/18/2022]
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Lynch S, Dixon J, Leary D. Reducing the Risk of Unplanned Perioperative Hypothermia. AORN J 2010; 92:553-62; quiz 563-5. [DOI: 10.1016/j.aorn.2010.06.015] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2010] [Revised: 06/06/2010] [Accepted: 06/13/2010] [Indexed: 11/25/2022]
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Developing a Successful Robotic Surgery Program in a Rural Hospital. AORN J 2010; 92:72-83; quiz 84-6. [DOI: 10.1016/j.aorn.2009.10.024] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2009] [Accepted: 10/23/2009] [Indexed: 11/18/2022]
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