Interventions to prevent hypothermia at birth in preterm and/or low birthweight babies

McCall, Emma; Alderdice, FA; Halliday, HL; Jenkins, J.; Vohra, Sunita

doi:10.1002/14651858.cd004210

Cited by 10 publications

(15 citation statements)

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“…There is much evidence to suggest that neonates who are not thermally regulated have a significantly higher risk of morbidity and mortality (Beck et al, 2004;Johanson et al, 1992;Lyon, 2004;Sinclair, 1992). Preterm, low birth weight or distressed neonates are more susceptible to hypothermia (McCall et al, 2005;WHO, 1997). The results from this study also indicate that the mode of cord cutting in rural areas might contribute to neonatal deaths through infection.…”

Section: Discussionmentioning

confidence: 99%

Understanding home-based neonatal care practice in rural southern Tanzania

Mrisho

Schellenberg

Mushi

et al. 2008

Transactions of the Royal Society of Tropical Medicine and Hygi

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SummaryIn order to understand home-based neonatal care practices in rural Tanzania, with the aim of providing a basis for the development of strategies for improving neonatal survival, we conducted a qualitative study in southern Tanzania. In-depth interviews, focus group discussions and case studies were used through a network of female community-based informants in eight villages of Lindi Rural and Tandahimba districts. Data collection took place between March 2005 and April 2007. The results show that although women and families do make efforts to prepare for childbirth, most home births are assisted by unskilled attendants, which contributes to a lack of immediate appropriate care for both mother and baby. The umbilical cord is thought to make the baby vulnerable to witchcraft and great care is taken to shield both mother and baby from bad spirits until the cord stump falls off. Some neonates are denied colostrum, which is perceived as dirty. Behaviour-change communication efforts are needed to improve early newborn care practices.

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Section: Discussionmentioning

confidence: 99%

Understanding home-based neonatal care practice in rural southern Tanzania

Mrisho

Schellenberg

Mushi

et al. 2008

Transactions of the Royal Society of Tropical Medicine and Hygi

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“…16,17 Axillary temperature was obtained immediately on admission to NICU by the nurse who attended the delivery, before transfer to a prewarmed incubator or warmer. To avoid selective recording of measurements, the method for confirming and recording out-of-target range readings were explicitly standardized in month 9 of the baseline period.…”

Section: Evaluation Methodsmentioning

confidence: 99%

Decreasing Hypothermia During Delivery Room Stabilization of Preterm Neonates

Pinheiro¹,

Furdon²,

Boynton³

et al. 2014

Pediatrics

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BACKGROUND AND OBJECTIVE: Hypothermia during delivery room stabilization of very low birth weight (VLBW) newborns is independently associated with mortality, yet it occurred frequently both in collaborative networks and at our institution. We aimed to attain admission temperatures in the target range of 36°C to 38°C in $90% of inborn VLBW neonates through implementation of a thermoregulation bundle.METHODS: This quality improvement project extended over 60 consecutive months, using sequential plan-do-check-act cycles. During the 14 baseline months, we standardized temperature measurements and developed the Operation Toasty Tot thermoregulation bundle (including consistent head and torso wrapping with plastic, warmed blankets, and a closed stabilization room). We introduced this bundle in month 15 and added servo-controlled, battery-powered radiant warmers for stabilization and transfer in month 21. We provided results and feedback to staff throughout, using simple graphics and control charts.RESULTS: There were 164 inborn VLBW babies before and 477 after bundle implementation. Introduction and optimization of the bundle decreased the incidence of hypothermia, with rates remaining in the target range for the last 13 study months. The incidence of temperatures .38°C was ∼2% both before and after bundle implementation.CONCLUSIONS: This thermoregulation bundle resulted in sustained improvement in normothermia rates during delivery room stabilization of VLBW newborns. Our benchmark goal of $90% admission temperatures above 36°C was met without increasing hyperthermia rates. Because these results compare favorably with those of recently published research or improvement collaboratives, we aim to maintain our performance through routine surveillance of admission temperatures. Pediatrics 2014;133:e218-e226 Dr Pinheiro contributed to the initial design and implementation of the project, collaborated in data acquisition, performed interim and final data analyses and interpretation, and drafted the initial manuscript; Ms Furdon contributed to the initial design and implementation of the project, collaborated in data acquisition, performed interim data analyses and interpretation, and collaborated in the initial draft and revisions of the manuscript; Ms Boynton, Ms Dugan, and Ms Reu-Donlon contributed to the initial design and implementation of the project, collaborated in data acquisition, and reviewed and revised the manuscript; Ms Jensen contributed to the initial design and implementation of the project, performed data analyses and interpretation in the early phases of the project, and reviewed and revised the manuscript; and all authors approved the final manuscript as submitted.www.pediatrics.org/cgi

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“…[1][2][3][4][5][6][7][8] Despite this recognition, hypothermia remains a significant challenge, especially in the perinatal care of preterm infants. Our clinical experience suggests that hypothermia remains an ongoing problem, especially among extremely low birth weight infants, even for those born in Level III perinatal centers.…”

Section: Introductionmentioning

confidence: 99%