Outpatient Surgery Magazine

More than half said a reduction in infections was why they warm, while 40% said fewer pain medications are needed for patients that are warmed and 37% said warming decreases compli- cations from anesthesia. Susan Franklin, RN, an infection preventionist at WellStar Cobb Hospital in Austell, Ga., recently completed a study of patients with SSIs, and found hypothermia was a factor — and instituted patient- warming practices as a solution. "More than 75% of patients with SSIs were hypothermic," says Ms. Franklin. "Hypothermia is rarely a problem intraoperatively now." Ms. Robinson notes that reducing patients' anxi- ety helps to reduce some of the other clinical com- plications the respondents noted. Less anxiety can lead to less post-operative pain, which means less medication is needed, and anxiety has been shown to prolong recovery times. Many ways to warm Nearly 86% use a forced-air warming system, and 80% use cotton blankets pre-warmed in a blanket warmer. Lesser-used methods: 14% use a spinal underbody blanket, thermal mattress or bed pad on which the patients lie; 8% use radiant warming devices and nearly 6% use conductive polymer fabrics that warm patients from above and below simultaneously. Eva Robbins, RN, BSN, surgery/specialty manag- er at Carroll County Memorial Hospital in Carrollton, Ky., says they warm all patients with cotton blankets from a warmer, as well as a forced-air warming system. The practice leads to happy patients and averts clinical com- plications, she says. "We continue to have satisfied patients, and we do not have any hypothermia cases in our sur- gery department," says Ms. Robbins. An underused solution? About 37% of respondents said they do not routine- ly warm patients. That's not enough, says Anita Volpe, DNP, APRN, director of surgical outcomes, research and education at NewYork-Presbyterian Queens in New York City. "Based upon all the evidence-based literature available, active pre-op warming should be a proto- col for all patients," says Ms. Volpe. Ms. Volpe has implemented warming protocols in 2 large facilities and says the pre-operative warming practices make a significant difference in achieving positive patient outcomes. Abdul Ghaffar Soomro, MSN, director of surgery and perioperative services at Prime Healthcare in Nogales, Ariz., agrees. "Warming of surgical patients, starting in the pre-op area and continuing until discharge, especially during the intraoperative period, is crucial," he says. One respondent noted that dealing with an infec- tion is expensive. "Research has shown a higher incidence of infection when temperatures are too low or too high. From a financial standpoint, keep- ing patients warm in a cold OR will help prevent infections, which we all know can cost thousands of dollars [to treat]," says the respondent. Rationales for whom to warm Nearly 62% of respondents say the length of sur- gery and 60% say the type of procedure are factors in whether to warm patients. Deborah O'Toole, 3 2 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • A U G U S T 2 0 1 9

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