Archive Staff & Patient Safety 2018

How Much Do You Know About Patient Warming?

A recent survey suggests some nurses are still stumped on the basics of preventing perioperative hypothermia.

Jeannette Sabatini, Associate Editor

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CONTINUING EDUCATION
CONTINUING EDUCATION Lessons about patient warming are needed to fill the gap between guideline recommendations and practice knowledge.

To keep patients normothermic during surgery, you initiate active warming measures in pre-op and take constant temperature readings to make sure their core body temperature remains above 36°C. Sounds simple enough, right? You’d think so, but a recent national survey of 324 perioperative nurses suggests there’s a gap between what the guidelines say about preventing hypothermia and what’s actually being done to prevent it. Chances are your nurses would benefit from a refresher course on the following topics and could use a reminder about why maintaining normothermia is an important part of providing safe surgical care.

  • Normothermia versus hypothermia. Many of the nurses overestimated or underestimated core body temperatures indicative of hypothermia and the lower and upper cutoffs for normothermia, says study lead author Karen K. Giuliano, PhD, RN, FAAN, MBA, an associate professor of nursing and executive director of healthcare innovation and entrepreNURSEship at Northeastern University in Boston, Mass.

AORN, the American Society of PeriAnesthesia Nurses (ASPAN) and the National Institute for Health and Clinical Excellence (NICE) define hypothermia as a core body temperature of less than 36°C. The nurses who responded to the survey reported an average hypothermia value of 35.1°C. That’s good, but the result had a standard deviation of 3.80, which in research-speak indicates many nurses overestimated or underestimated the core body temperature indicative of hypothermia. The nurses also reported an average value of 35.1°C for the low cutoff point for normothermia, which was lower than limits recommended by ASPAN and NICE.

“That OR nurses with a significant amount of experience and education were not always familiar with the temperature ranges and definitions of hypothermia and normothermia suggests a need for ongoing education and a more widespread dissemination of available patient warming guidelines,” says Dr. Giuliano.

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