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Hypothermia: prevention and management in adults having surgery [CG65]

Measuring the use of this guidance

Recommendation: 1.1.1

Patients (and their families and carers) should be informed that: • staying warm before surgery will lower the risk of postoperative complications • the hospital environment may be colder than their own home • they should bring additional clothing, such as a dressing gown, a vest, warm clothing and slippers, to help them keep comfortably warm • they should tell staff if they feel cold at any time during their hospital stay.

What was measured: Proportion of patients who underwent surgery and received information on inadvertent peri-operative hypothermia.
Data collection end: September 2014
60%
Number that met the criteria: 60 / 100
Area covered: Local
Source: Shah R.M (2015) NICE and warm: Inadvertent peri-operative hypothermia. Anaesthesia, conference; var.pagings


Recommendation: 1.2.4

The patient's temperature should be measured and documented in the hour before they leave the ward or emergency department.

What was measured: Proportion of patients who underwent surgery and had a temperature recorded pre-operatively.
Data collection end: September 2014
92%
Number that met the criteria: 92 / 100
Area covered: Local
Source: Shah R.M (2015) NICE and warm: Inadvertent peri-operative hypothermia. Anaesthesia, conference; var.pagings


Recommendation: 1.3.1

The patient’s temperature should be measured and documented before induction of anaesthesia and then every 30 minutes until the end of surgery

What was measured: Proportion of surgical patients that had documentation of temperature prior to induction of anaesthesia.
Data collection end: June 2014
14%
Area covered: Local
Source: Zhang XW (2014) Intra-operative temperature management: An audit and quality improvement project. Anaesthesia October: var.pagings

What was measured: Proportion of surgical patients that had documentation of temperature during anaesthesia.
Data collection end: June 2014
38%
Area covered: Local
Source: Zhang XW (2014) Intra-operative temperature management: An audit and quality improvement project. Anaesthesia October: var.pagings


Recommendation: 1.3.1

The patient's temperature should be measured and documented before induction of anaesthesia and then every 30 minutes until the end of surgery

What was measured: Proportion of patients who had their temperature recorded every 30 min intraoperatively.
Data collection end: May 2014
3%
Number that met the criteria: 1 / 37
Area covered: Local
Source: Wythe S.R (2014) Perioperative temperature management: Blowing hot and cold?


Recommendation: 1.3.3

Induction of anaesthesia should not begin unless the patient's temperature is 36.0°C or above (unless there is a need to expedite surgery because of clinical urgency, for example bleeding or critical limb ischaemia).

What was measured: Proportion of patients who underwent surgery and had a temperature above 36.0°C prior to anaesthesia.
Data collection end: September 2014
90%
Number that met the criteria: 90 / 100
Area covered: Local
Source: Shah R.M (2015) NICE and warm: Inadvertent peri-operative hypothermia. Anaesthesia, conference; var.pagings


Recommendation: 1.3.5

The patient should be adequately covered throughout the intraoperative phase to conserve heat, and exposed only during surgical preparation.

What was measured: Proportion of surgical patients for whom an external warmer was used.
Data collection end: June 2014
56%
Area covered: Local
Source: Zhang XW (2014) Intra-operative temperature management: An audit and quality improvement project. Anaesthesia October: var.pagings


Recommendation: 1.3.6

Intravenous fluids (500 ml or more) and blood products should be warmed to 37°C using a fluid warming device.

What was measured: Proportion of surgical patients where a fluid warming device was used.
Data collection end: June 2014
40%
Area covered: Local
Source: Zhang XW (2014) Intra-operative temperature management: An audit and quality improvement project. Anaesthesia October: var.pagings


Recommendation: 1.4.1

The patient's temperature should be measured and documented on admission to the recovery room and then every 15 minutes. • Ward transfer should not be arranged unless the patient's temperature is 36.0°C or above. • If the patient's temperature is below 36.0°C, they should be actively warmed using forced air warming until they are discharged from the recovery room or until they are comfortably warm.

What was measured: Proportion of patients who underwent surgery and were discharged from recovery with temperature above 36.0°C.
Data collection end: September 2014
100%
Number that met the criteria: 100 / 100
Area covered: Local
Source: Shah R.M (2015) NICE and warm: Inadvertent peri-operative hypothermia. Anaesthesia, conference; var.pagings



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