Purpose for the Program
The purpose of this presentation is to share an evidence-based practice process to meet the Surgical Care Improvement Project criteria of the patient temperature on admission to the post-anesthesia care unit (PACU) of 36°C. This practice also shows a reduction in nursing interventions to treat hypothermia in the PACU and a significant reduction in surgical site infections after cesarean birth.
To warm the maternal-surgical patient with a forced air warmer prior to entering the operating room.
Implementation, Outcomes, and Evaluation
All maternity patients are warmed during the preoperative period for 30 minutes. This preoperative warming occurs while the admitting nurse is doing other tasks, such as taking the patient history, starting the intravenous line, and monitoring the fetal heart tones. The outcome of this project shows that the surgical site infection rate after cesarean dropped from 2.6% to 1.5% during the quarter in which the project was implemented. Because of the reduced infection rate, costs are reduced for patient readmissions to the hospital and repeat visits to a physician's office for surgical site care.
Implications for Nursing Practice
Implications for nursing practice involve a one-step preoperational warming process that takes place during the preoperative period with a forced air warmer for scheduled cesareans. This practice takes place during the time the nurse is doing other tasks to prepare the patient for surgery. On admission to the PACU, fewer nursing interventions are required to treat hypothermia after the surgery.