Poster Competition INMO Operating Department Conference
One of the posters sent from the Operating Theatre Department CUH won 2nd prize at the INMO Operating Department National Conference on Saturday March 25th.
Please click here to view poster.
Abstract: Perioperative normothermia (core body temperature 36 – 37.5°Celcius)is a necessary factor in maintaining patient safety, achieving positive surgical outcomes and patient satisfaction. Significantly, maintaining normothermia has been proven to decrease the postoperative length of hospital stay by as much as 40%, and has been shown to decrease the risk of surgical site infections by 64% (Lynch, Dixon & Leary, 2010).
A nurse-led clinical audit was undertaken in the Operating Theatre Department of Cork University Hospital (CUH) from November 2016 to February 2017. The purpose of this audit was to establish the incidence of Inadvertent Perioperative Hypothermia (IPH) in the department, and examine how staff managed patient care to prevent it from occurring. IPH is defined as a core body temperature less than 36° C (Hart et al, 2011). The process also set out to raise awareness amongst PeriOperative healthcare staff on the importance of and recognition of IPH, to illustrate the impact it has on surgical patients and to improve patient outcomes.
This nurse led audit, which occurred in consultation with Department of Anaesthesia and Department of Surgery, sought to determine at what specific part of the perioperative pathway the issue of IPH commences, what interventions were put in place and their effectiveness. The audit tool was developed by the authors, with input from two Consultant
Anaesthetists and one General Surgical Consultant. The questions were based on evidence from both local policy and NICE guidelines (2008). 100 patients (both adults and children) were included in the audit which was conducted over a 4 month period. The following surgical specialities were involved in the process; breast, urology, vascular, cardiac and emergency surgery. Patient care in the recovery room was captured for all patients in this context. Each patient’s temperature was recorded at 5 different times during the peri-operative pathway (on arrival to theatre reception, on arrival to theatre suite, leaving theatre suite, arrival to recovery room, leaving recovery room) and the warming intervention used were noted. Patient details, the surgery performed and the patient’s risk factors were recorded. These risk factors included patient exposure, type of anaesthesia (+/- combined), fasting time (reduced metabolism), patient’s age, health status (ASA Grade 2 or over), cardiovascular disease, BMI, major surgery (> 2 hours, abdominal), use of premedication amongst others (AORN, 2014).
The results of audit have been correlated and will be used to inform quality improvement initiatives with the intention of improving patient care standards in the Operating Theatre Department, CUH. Improvements to date include increased staff awareness of the incidence of IPH and the patient care interventions required in order to prevent it. Individual consideration is now given to each patient by incorporating warming measures as early as possible in their perioperative pathway. Additional thermometers have been made readily available throughout the department to
assess and monitor patient temperature during their PeriOperative journey. Finally, the policy on prevention and management of IHP in CUH has been reviewed and updated accordingly.