About this blog
We have been doing an interesting study in Princess Anne Hospital since February looking at the natural history of neonatal temperatures from birth to admission to the neonatal unit at Princess Anne Hospital Southampton. We have had issues with babies under 31 weeks gestation coming with temperatures under 36.5C which is a key quality indicator for us nationally. We have tried to practice a standardized approach to this as highlighted in the video below. We simulate this often with every new intake of doctors and in different places in our hospital.
Using a simulated approach we have had better thermal outcomes since 2011 till last year.
We have taken the standardization a step further and by doing a study of temperatures from birth to admission to the neonatal unit we are trying to understand where in the process we are failing. We have practiced this but have now adopted what I will call a 'PITSTOP Approach' as practiced in Formula 1. In this clear delegation and responsibilities are underlined whether this is an emergency or an elective delivery under 31 weeks. The baby will have DCC for 1 minute (where appropriate) and then go into a plastic bag. There is a person incharge of the Airway, person in charge of Access BUT it is our Nurse coordinator who will apply the saturation probe to the right hand followed by application of the temperature probe to the right axilla and setting the resuscitaire to baby servo. She keeps an eye on the temperature very carefully throughout the resuscitation and we will use a transwarmer if the baby is under 36.6 at 10 minutes. Using this approach so far in 13 babies we have not had a baby with a temperature under 36.6 or above 37.5. Early days for our QI project but will keep you updated.