Warming Up in the Operating Theatre!

Nursing has moved away from evidence based on tradition which was often flawed and moved towards care based on accountability, effectiveness, efficiency and systematic evaluation. Today nurses use good evidence to challenge... [ view full abstract ]

Nursing has moved away from evidence based on tradition which was often flawed and moved towards care based on accountability, effectiveness, efficiency and systematic evaluation. Today nurses use good evidence to challenge and justify practice thus providing the highest standard of care. Peri-operatively patients are vulnerable to many adverse outcomes such as inadvertent hypothermia. Data described by Bellamy(2007) suggests that 70% of patients experience inadvertent hypothermia. Complications as depicted by Roberson et al (2013) include altered clotting function and increased incidence of infection. Guidelines from the Royal College of Surgeons in Ireland (2012)states that the patients temperature should be maintained at 36 degrees peri-operatively to prevent surgical wound infection. Additionally guidelines from the National Institute of Clinical Excellence (2008) provide minimum standards that should be met to prevent hypothermia peri-operatively.
The aim of the audit was to establish if the current practice employed by the authors department met current recommended evidence based guidelines.

A concurrent audit on 43 patients was employed in this project.

The findings suggested that 12% of patients were hypothermic prior to induction of anaesthesia, with 53% of patients hypothermic post-operatively on admission to the Recovery Room. 25% of patients had received forced air warming and 18% had intravenous fluids warmed peri-operatively. 5% of patients had increased length of stay on Recovery due to inadvertent hypothermia.

To conclude this audit indicates that there needs to be an increased focus on prevention of inadvertent hypothermia peri-operatively. Audit findings need to be made available to the multi-disciplinary team with further education provided to improve deficits in current practice. A Quality Improvement Project is being deliberated locally to include short periods of Pre-Warming of patients as depicted by Horn et al (2012) to help maintain normothermia peri-operatively.