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Date of Award

5-2-2014

Degree Type

Restricted Evidence-Based Project Report

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Elise M. Alverson

Abstract

Inadvertent perioperative hypothermia (IPH) is a common occurrence and it persists despite the correlation between IPH and postoperative morbidity. The purpose of this EBP project was to answer the PICOT question: In the perioperative setting, what is the effect of an IPH protocol compared with no IPH protocol on patients’ temperature throughout the perioperative course over a two month period? Rogers’ Diffusion of Innovation and the Stetler model of EBP were used to guide the project. After appraising the literature, an IPH protocol was developed, IRB approval was obtained, and the protocol was implemented at a military treatment facility. Data was collected on the protocol adherence as well as the perioperative body temperature. A retrospective chart review was completed for comparison. Data were transferred into SPSS-22 and analyzed. The overall IPH protocol adherence rate was 50.8%. Pre-implementation (n=97) and post-implementation groups (n=97) groups were analyzed with t-test. Improvement in mean temperature upon arrival to the PACU was not significant (p =.38); improvement in mean temperature upon discharge from the PACU was significant (p < .00). During implementation, 0% of patients were hypothermic upon discharge from the PACU compared with 13.8% before implementation. The perioperative temperature compliance metric, indicating a temperature > 96.8°F within 30 minutes of surgical end time, increased from 89% to 94.9% during implementation. The EBP project demonstrated improved perioperative thermoregulation. Future projects should address ways to improve IPH protocol adherence. Recommendations include educating staff on current IPH prevention and treatment strategies and incorporating current IPH protocol recommendations into organizational practice using a team based approach.

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