Neonatal Intensive Care Unit, University Hospital Galway, Galway, Ireland.
School of Nursing and Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland.
J Spec Pediatr Nurs. 2020 Apr;25(2):e12286. doi: 10.1111/jspn.12286. Epub 2020 Jan 7.
The purpose of this review was to ascertain the impact of thermoregulation quality improvement initiatives (QIs) on the admission temperatures of premature/very-low-birth-weight infants in neonatal intensive care units (NICUs).
A systematic search of databases Cumulative Index to Nursing and Allied Health Literature, Medline, Embase, and the Cochrane library was carried out. Specific inclusion and exclusion criteria were adhered to, with no publication date limitations added. The chosen studies were examined for quality, data were extracted and analysed, before a narrative synthesis was performed. The last search occurred on January 7, 2019, with PRISMA flow diagrams completed for identified studies.
Ten studies of varying methodology design were included in this review. Variations of thermoregulation interventions were included in the 10 studies. Nevertheless, all of them demonstrated that admission temperature rates can be significantly improved by implementing a thermoregulation QI. The multidisciplinary team and ongoing education were seen as much needed components to the overall sustainability, and continuing success of the QI's.
This systematic review determines that thermoregulation QIs can positively impact the admission temperatures of premature/very-low-birth-weight infants in the NICU. Prevention of hypothermia is aimed at reducing the risks of developing major neonatal morbidities. The pooling of the results from the 10 studies helps in the sharing of outcome measures and thus, improving quantitative synthesis. More frequent monitoring of the axillary temperature would help in preventing hypothermia and hyperthermia occurring. Ongoing education and staff training are essential for managing thermoregulation successfully. Examining the compliance rates to such quality initiatives, and the variations in interventions would benefit from further research to ensure better standardisation of clinical practice.
本综述旨在确定体温调节质量改进措施（QI）对新生儿重症监护病房（NICU）中早产儿/极低出生体重儿入院体温的影响。
系统检索了 Cumulative Index to Nursing and Allied Health Literature、Medline、Embase 和 Cochrane 图书馆数据库。遵循特定的纳入和排除标准，未添加任何出版日期限制。对选定的研究进行了质量检查，提取和分析数据，然后进行叙述性综合。最后一次搜索于 2019 年 1 月 7 日进行，并为确定的研究完成了 PRISMA 流程图。
本综述纳入了 10 项不同方法学设计的研究。这 10 项研究均包含不同的体温调节干预措施。然而，所有研究都表明，通过实施体温调节 QI，可以显著提高入院体温率。多学科团队和持续教育被视为整体可持续性和 QI 持续成功的必要组成部分。
本系统评价确定体温调节 QI 可以对 NICU 中早产儿/极低出生体重儿的入院体温产生积极影响。预防低体温旨在降低发生主要新生儿并发症的风险。10 项研究结果的汇总有助于共享结果测量指标，从而改善定量综合。更频繁地监测腋温有助于预防低体温和体温过高的发生。持续的教育和员工培训对于成功管理体温调节至关重要。进一步研究检查对这些质量举措的依从率以及干预措施的变化，将有助于更好地标准化临床实践。
