Purpose: Unintentional hypothermia is defined as a core body temperature below 36°C. The most frequent warming protocols in major surgeries and/or surgeries lasting more than 60 minutes are active warming methods initialized be the anesthesia team. The goal of this study was to evaluate the adherence to a protocol initiating forced-air warming by the nursing staff in the operating rooms during the immediate preoperative period. We also to assessed the effects of different prewarming times on intraoperative temperatures, specifically redistribution hypothermia due to induction of anesthesia. Method: The study was conducted in a surgery center and comprised the development of the pre-warming protocol, training of the nursing staff and data collection in April and May of 2015. Oral thermometers were used for up to 50 minutes during the pre-anesthesia period (depending on length of pre-warming) and esophageal temperatures were measured every 30 minutes throughout anesthesia (starting with intubation). Descriptive analyses of demographic data, core temperatures and types of forced-air warming devices were conducted. We also compared core temperatures at 60 minutes after induction. ANOVA and Tukey's test were used to analyze the core temperatures of the groups. Significant differences were considered significant when p < 0.05. Results: We studies 146 patients. Protocol adherence was 64% in the first month and 89% in the second month of the study. We observed that 30, 40 and 50 minutes of pre-warming resulted in significant decreases in redistribution hypothermia.
Half of the critical incidents (CI) at hospital environment occur in the operating room. The main contributory factor involved is the so-called "human factor". This term refers to both the non-technical skills that each one has as well as teamwork. The main non-technical skills are communication, coordination, shared mental model and leadership skills. Of these, communication capacity is essential because it connects the other elements.
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