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J U LY 2 0 1 4 | S U P P L E M E N T T O O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E
can minimize the risks they create.
• Limit inhalational agents.
From an inhalation standpoint, anything you give
patients to breathe will affect their core temperature, because anesthetic gases
and oxygen are inherently cold. Heat is lost from the airway by way of evapora-
P A T I E N T M A N A G E M E N T
There may be a gap
between compliance with
quality performance meas-
ures that demand warming
and competent maintenance
of patient normothermia,
according to Victoria M.
Steelman, PhD, RN, CNOR, FAAN, an assistant professor of nursing at the University
of Iowa in Iowa City.
For a study (
tinyurl.com/nggv84g
) published online in the Journal for Healthcare
Quality in January, Dr. Steelman and her colleagues reviewed the cases of patients
undergoing surgery at a community hospital, with general and regional anesthesia,
over the course of 48 months. They found that 5.8% of the patients for whom the
Joint Commission and CMS quality performance measure for active warming was
met were actually hypothermic when admitted to PACU. Broken down by specialty,
urology (8.5% of patients) and orthopedics (7.7%) had the highest percentage of
warmed patients who were hypothermic in PACU.
"Patients who receive care compliant with the quality performance measure by
receiving active warming are still at risk for hypothermia," writes Dr. Steelman. This
highlights the need for routine monitoring of patients' core temperatures in recov-
ery, regardless of how diligently you work to maintain normothermia throughout
their care.
— David Bernard
COMPLIANCE QUESTION
Are Warming Efforts Effective?
GET CONNECTED Effective anesthesia and efficient
recovery can be complicated by hypothermia.
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