• Ella Schwarzmann Aley-Raz, Gil Talmon, Marina Peniakov, Jamal Hasanein, Clari Felszer-Fisch, and Scott A Weiner.
• Department of Pediatrics Ward B, Emek Medical Center, Afula, Israel.
• Isr Med Assoc J. 2020 Sep 1; 9 (22): 476-480.

BackgroundNeonatal hypothermia (< 36°C) has been associated with both neonatal morbidity and mortality.ObjectivesTo develop a multifactorial approach to reduce the incidence of neonatal hypothermia at admission to the neonatal intensive care unit.MethodsThe approach involved a detailed quality improvement (QI) plan, which included the use of occlusive wrapping and exothermic mattresses as well as higher delivery and operating room environmental temperatures. The improvement plan was implemented over a 10-month period. Retrospective comparison to the same 10-month period during the previous year assessed the effectiveness of the approach in reducing the incidence of admission hypothermia.ResultsThe QI project included 189 patients. These patients were compared to 180 patients during the control period. The characteristics of the patient groups were similar and included preterm infants, who were subsequently analyzed as a subgroup. We found a significant reduction in the incidence of hypothermia, which was most profound for the subgroup of premature infants born at < 32 weeks gestation. Neonatal hyperthermia was identified as an unintended consequence of the project, and subsequently improved after initiating simple preventive measures.ConclusionsOcclusive wrapping, exothermic mattresses, and higher delivery and operating room environmental temperature may be successful in reducing admission neonatal hypothermia.

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