Godfrey Kathleen, Nativio Donna G, Bender Charles V, Schlenk Elizabeth A
Department of Health Promotion and Development, University of Pittsburgh School of Nursing (Drs Godfrey and Nativio); Department of Pediatrics and Obstetrics and Gynecology, University of Pittsburgh School of Medicine (Dr Bender); and Department of Health and Community Systems, University of Pittsburgh School of Nursing (Dr Schlenk), Pennsylvania.
Adv Neonatal Care. 2013 Oct;13(5):311-6. doi: 10.1097/ANC.0b013e31828d040a.
The aim of this quality improvement initiative was to improve the neonatal intensive care unit (NICU) admission rectal temperatures of premature infants less than 28 weeks' gestation by placing them in an occlusive bag from the neck down immediately after birth. The historical control group consisted of a convenience sample of 46 very low-birth-weight infants from March 1, 2010, to August 31, 2010. A convenience sample of 35 very low-birth-weight infants from October 1, 2010, to April 30, 2011, was recruited during the prospective phase. A quasi-experimental design was used. A retrospective medical record review was performed to collect data on NICU admission rectal temperatures for the historical control group. During the prospective phase, infants were placed in a bag from the neck down immediately after birth and NICU admission rectal temperatures were recorded. In both groups, NICU rectal temperatures were measured immediately upon admission. Application of the bag resulted in a higher mean NICU admission rectal temperature in the intervention group compared with the historical control group. Occlusive bags applied at delivery decreased heat loss in premature infants. The results support previous findings and resulted in a change in clinical practice.
这项质量改进举措的目的是，通过在出生后立即将胎龄小于28周的早产儿从颈部以下置于封闭袋中，来提高新生儿重症监护病房（NICU）收治时的直肠温度。历史对照组由2010年3月1日至2010年8月31日期间46例极低出生体重儿的便利样本组成。前瞻性阶段招募了2010年10月1日至2011年4月30日期间35例极低出生体重儿的便利样本。采用了准实验设计。对历史对照组进行回顾性病历审查以收集NICU收治时直肠温度的数据。在前瞻性阶段，婴儿出生后立即从颈部以下置于袋中，并记录NICU收治时的直肠温度。两组均在入院时立即测量NICU直肠温度。与历史对照组相比，干预组使用袋子后NICU收治时的平均直肠温度更高。分娩时使用封闭袋可减少早产儿的热量损失。这些结果支持了先前的发现，并导致了临床实践的改变。
