Improving the rate of surgical normothermia in gynecologic surgery

Amanika Kumar, David P. Martin, Sarah R. Dhanorker, Sharon R. Brandt, Darrell R. Schroeder, Andrew C. Hanson, Robert R. Cima, Sean Christopher Dowdy

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective: To increase the rate of normothermia (core temperature ≥ 36 °C) in patients undergoing gynecologic surgery. Methods: The rate of surgical normothermia was evaluated in a single institution. A two-phase quality improvement project was undertaken; Phase 1 included the use of intra-operative room temperature regulation and intra-operative patient warming and Phase 2 included pre-operative patient warming. Clinical characteristics, median temperatures, and rate of normothermia were abstracted for patients in each phase. Cohorts were compared using chi-square and t-tests. Results: The project was performed in two phases, each with a historic and intervention cohort. There were 503 patients in the historical cohort and 636 patients in the intervention cohort in phase 1; there were 291 patients in the historical cohort and 259 patients in the intervention cohort for Phase 2. Patient characteristics and anesthetic type and duration did not differ between cohorts. After intra-operative temperature regulation and patient warming in Phase 1, significantly more patients achieved normothermia (79% versus 68%, P < 0.0001). However operating room staff were more likely to rate the temperature as very hot in 40% of cases post-intervention, compared to only 2% historically. In Phase 2, after the intervention of pre-warming patients, there was no difference in achieving normothermia, 78% versus 83%, P = 0.09. Staff had no statistical difference in personal comfort with the temperature, however did feel efforts were very effective more frequently, 7.7% historic versus 32.7% post-intervention, P < 0.0001. Conclusions: Quality improvement methodology can be applied to pre- and intra-operative decision making to improve rates of surgical patient normothermia.

Original languageEnglish (US)
JournalGynecologic oncology
DOIs
StatePublished - Jan 1 2019

Fingerprint

Gynecologic Surgical Procedures
Temperature
Quality Improvement
Operating Rooms
Chi-Square Distribution
Anesthetics
Decision Making

Keywords

  • Health care
  • Hypothermia
  • Normothermia
  • PACU
  • Postanesthesia care unit
  • Surgical site infections

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

Cite this

Kumar, A., Martin, D. P., Dhanorker, S. R., Brandt, S. R., Schroeder, D. R., Hanson, A. C., ... Dowdy, S. C. (2019). Improving the rate of surgical normothermia in gynecologic surgery. Gynecologic oncology. https://doi.org/10.1016/j.ygyno.2019.06.027

Improving the rate of surgical normothermia in gynecologic surgery. / Kumar, Amanika; Martin, David P.; Dhanorker, Sarah R.; Brandt, Sharon R.; Schroeder, Darrell R.; Hanson, Andrew C.; Cima, Robert R.; Dowdy, Sean Christopher.

In: Gynecologic oncology, 01.01.2019.

Research output: Contribution to journalArticle

Kumar, A, Martin, DP, Dhanorker, SR, Brandt, SR, Schroeder, DR, Hanson, AC, Cima, RR & Dowdy, SC 2019, 'Improving the rate of surgical normothermia in gynecologic surgery', Gynecologic oncology. https://doi.org/10.1016/j.ygyno.2019.06.027
Kumar A, Martin DP, Dhanorker SR, Brandt SR, Schroeder DR, Hanson AC et al. Improving the rate of surgical normothermia in gynecologic surgery. Gynecologic oncology. 2019 Jan 1. https://doi.org/10.1016/j.ygyno.2019.06.027
Kumar, Amanika ; Martin, David P. ; Dhanorker, Sarah R. ; Brandt, Sharon R. ; Schroeder, Darrell R. ; Hanson, Andrew C. ; Cima, Robert R. ; Dowdy, Sean Christopher. / Improving the rate of surgical normothermia in gynecologic surgery. In: Gynecologic oncology. 2019.
@article{2b8a028361a441aca75086f2818f1bae,
title = "Improving the rate of surgical normothermia in gynecologic surgery",
abstract = "Objective: To increase the rate of normothermia (core temperature ≥ 36 °C) in patients undergoing gynecologic surgery. Methods: The rate of surgical normothermia was evaluated in a single institution. A two-phase quality improvement project was undertaken; Phase 1 included the use of intra-operative room temperature regulation and intra-operative patient warming and Phase 2 included pre-operative patient warming. Clinical characteristics, median temperatures, and rate of normothermia were abstracted for patients in each phase. Cohorts were compared using chi-square and t-tests. Results: The project was performed in two phases, each with a historic and intervention cohort. There were 503 patients in the historical cohort and 636 patients in the intervention cohort in phase 1; there were 291 patients in the historical cohort and 259 patients in the intervention cohort for Phase 2. Patient characteristics and anesthetic type and duration did not differ between cohorts. After intra-operative temperature regulation and patient warming in Phase 1, significantly more patients achieved normothermia (79{\%} versus 68{\%}, P < 0.0001). However operating room staff were more likely to rate the temperature as very hot in 40{\%} of cases post-intervention, compared to only 2{\%} historically. In Phase 2, after the intervention of pre-warming patients, there was no difference in achieving normothermia, 78{\%} versus 83{\%}, P = 0.09. Staff had no statistical difference in personal comfort with the temperature, however did feel efforts were very effective more frequently, 7.7{\%} historic versus 32.7{\%} post-intervention, P < 0.0001. Conclusions: Quality improvement methodology can be applied to pre- and intra-operative decision making to improve rates of surgical patient normothermia.",
keywords = "Health care, Hypothermia, Normothermia, PACU, Postanesthesia care unit, Surgical site infections",
author = "Amanika Kumar and Martin, {David P.} and Dhanorker, {Sarah R.} and Brandt, {Sharon R.} and Schroeder, {Darrell R.} and Hanson, {Andrew C.} and Cima, {Robert R.} and Dowdy, {Sean Christopher}",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.ygyno.2019.06.027",
language = "English (US)",
journal = "Gynecologic Oncology",
issn = "0090-8258",
publisher = "Academic Press Inc.",

}

TY - JOUR

T1 - Improving the rate of surgical normothermia in gynecologic surgery

AU - Kumar, Amanika

AU - Martin, David P.

AU - Dhanorker, Sarah R.

AU - Brandt, Sharon R.

AU - Schroeder, Darrell R.

AU - Hanson, Andrew C.

AU - Cima, Robert R.

AU - Dowdy, Sean Christopher

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objective: To increase the rate of normothermia (core temperature ≥ 36 °C) in patients undergoing gynecologic surgery. Methods: The rate of surgical normothermia was evaluated in a single institution. A two-phase quality improvement project was undertaken; Phase 1 included the use of intra-operative room temperature regulation and intra-operative patient warming and Phase 2 included pre-operative patient warming. Clinical characteristics, median temperatures, and rate of normothermia were abstracted for patients in each phase. Cohorts were compared using chi-square and t-tests. Results: The project was performed in two phases, each with a historic and intervention cohort. There were 503 patients in the historical cohort and 636 patients in the intervention cohort in phase 1; there were 291 patients in the historical cohort and 259 patients in the intervention cohort for Phase 2. Patient characteristics and anesthetic type and duration did not differ between cohorts. After intra-operative temperature regulation and patient warming in Phase 1, significantly more patients achieved normothermia (79% versus 68%, P < 0.0001). However operating room staff were more likely to rate the temperature as very hot in 40% of cases post-intervention, compared to only 2% historically. In Phase 2, after the intervention of pre-warming patients, there was no difference in achieving normothermia, 78% versus 83%, P = 0.09. Staff had no statistical difference in personal comfort with the temperature, however did feel efforts were very effective more frequently, 7.7% historic versus 32.7% post-intervention, P < 0.0001. Conclusions: Quality improvement methodology can be applied to pre- and intra-operative decision making to improve rates of surgical patient normothermia.

AB - Objective: To increase the rate of normothermia (core temperature ≥ 36 °C) in patients undergoing gynecologic surgery. Methods: The rate of surgical normothermia was evaluated in a single institution. A two-phase quality improvement project was undertaken; Phase 1 included the use of intra-operative room temperature regulation and intra-operative patient warming and Phase 2 included pre-operative patient warming. Clinical characteristics, median temperatures, and rate of normothermia were abstracted for patients in each phase. Cohorts were compared using chi-square and t-tests. Results: The project was performed in two phases, each with a historic and intervention cohort. There were 503 patients in the historical cohort and 636 patients in the intervention cohort in phase 1; there were 291 patients in the historical cohort and 259 patients in the intervention cohort for Phase 2. Patient characteristics and anesthetic type and duration did not differ between cohorts. After intra-operative temperature regulation and patient warming in Phase 1, significantly more patients achieved normothermia (79% versus 68%, P < 0.0001). However operating room staff were more likely to rate the temperature as very hot in 40% of cases post-intervention, compared to only 2% historically. In Phase 2, after the intervention of pre-warming patients, there was no difference in achieving normothermia, 78% versus 83%, P = 0.09. Staff had no statistical difference in personal comfort with the temperature, however did feel efforts were very effective more frequently, 7.7% historic versus 32.7% post-intervention, P < 0.0001. Conclusions: Quality improvement methodology can be applied to pre- and intra-operative decision making to improve rates of surgical patient normothermia.

KW - Health care

KW - Hypothermia

KW - Normothermia

KW - PACU

KW - Postanesthesia care unit

KW - Surgical site infections

UR - http://www.scopus.com/inward/record.url?scp=85068366930&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85068366930&partnerID=8YFLogxK

U2 - 10.1016/j.ygyno.2019.06.027

DO - 10.1016/j.ygyno.2019.06.027

M3 - Article

C2 - 31285083

AN - SCOPUS:85068366930

JO - Gynecologic Oncology

JF - Gynecologic Oncology

SN - 0090-8258

ER -