Department of Neonatal Medicine and Surgery, NIHR Southampton Biomedical Research Centre, Princess Anne Hospital Southampton, Southampton, UK.
Department of Neonatal Medicine and Surgery, Princess Anne Hospital Southampton, Southampton, UK.
Acta Paediatr. 2021 Oct;110(10):2745-2752. doi: 10.1111/apa.16009. Epub 2021 Jul 14.
To achieve the National Neonatal Audit Programme (NNAP) standard of 90% normothermia among preterm infants born under 30 weeks of gestation.
Project SHIP (Stopping Hypothermia In Premmies) was a quality improvement programme to improve admission normothermia. Phase 1 of the project implemented low-fidelity simulations during 2011-2016. In Phase 2 (2017), a multimodal approach to quality improvement was used, including in situ simulations, videos of simulated scenarios, an allocated team member for thermal care, a clear protocol for thermal care, a coordinating 'lollipop man' role and monthly performance feedback. Additionally, continuous temperature monitoring using servo-control during stabilisation was introduced during Phase 2. Phase 3 (2018-2019) focused on embedding practice and maintaining performance.
Phase 1 initiatives resulted in improvement of normothermia rates from 58% to 75%. However, the results plateaued. During Phase 2, the hypothermia rate fell from 16% to 3%. During Phase 3, this improvement in the hypothermia rate was sustained, achieving the standard of 90% normothermia in 2018 and falling just short in 2019 due to an increased hyperthermia rate.
A multimodal quality improvement approach achieved sustained improvement in normothermia. Continuous temperature monitoring during stabilisation allows resuscitating teams to plan interventions to treat hypothermia and hyperthermia.
达到国家新生儿审核计划（NNAP）标准，即 30 周以下早产儿的核心体温维持在正常范围内的比例达到 90%。
项目 SHIP（阻止早产儿低体温）是一项旨在改善入院时体温正常化的质量改进项目。该项目的第一阶段（2011-2016 年）实施了低保真模拟。在第二阶段（2017 年），采用了多模式的质量改进方法，包括现场模拟、模拟场景视频、专门负责体温护理的团队成员、明确的体温护理方案、协调的“棒棒糖人”角色以及每月的绩效反馈。此外，在第二阶段期间引入了使用伺服控制进行稳定期连续体温监测。第三阶段（2018-2019 年）专注于实践的嵌入和绩效的维持。
第一阶段的举措使体温正常化率从 58%提高到 75%。然而，结果趋于平稳。在第二阶段，低体温率从 16%下降到 3%。在第三阶段，低体温率的改善得以维持，2018 年达到了 90%体温正常化的标准，2019 年由于体温过高率增加而略有不足。
多模式质量改进方法实现了体温正常化的持续改善。稳定期的连续体温监测使复苏团队能够计划干预措施来治疗低体温和体温过高。
