REDUCING ADMISSION HYPOTHERMIA IN NEWBORNS USING SIMPLE THERMOREGULATION MEASURES: A QUALITY IMPROVEMENT STUDY

Abstract

Admission hypothermia is a common yet preventable problem in newborns and is associated with increased morbidity and mortality, particularly among preterm and low-birth-weight infants.

Aim: To reduce the incidence of admission hypothermia in newborns through implementation of simple, low-cost thermoregulation measures.

Methods: A pre- and post-intervention quality improvement study was conducted in a tertiary care hospital over a 6-month period. A total of 52 neonates were included, comprising 29 inborn and 23 outborn babies. Baseline (pre-PDSA) data were collected from 20 neonates, followed by sequential Plan–Do–Study–Act (PDSA) cycles, after which 32 neonates were evaluated. Interventions included staff sensitization, optimization of delivery room temperature, use of pre-warmed linen and head caps, application of plastic wrap in eligible preterm infants, reduction of delivery room-to-NICU shifting time to less than 30 minutes, and standardized transport practices. The primary outcome was the proportion of newborns with normothermia on admission.

Results: Admission hypothermia decreased from 50% (10/20) in the pre-intervention phase to 28.1% (9/32) post-intervention (p < 0.05). Improvements were observed in both inborn and outborn neonates. Mean delivery room-to-NICU transfer time for inborn neonates decreased significantly.

Conclusion: Simple thermoregulation practices combined with timely transfer significantly reduce admission hypothermia in both inborn and outborn neonates. These low-cost interventions are feasible and sustainable in routine neonatal care, even in resource-limited settings.