Clinical Survey of Current Perioperative Body Temperature Management: What Major Factors Influence Effective Hypothermia Prevention Practice?

Abstract

Xiaoqian Deng,1 Junyu Yan,2 Shaungwen Wang,3 Yifan Li,3 Yun Shi4 1Department of Anesthesiology, West China Hospital, Sichuan University and The Research Units of West China (2018RU012), Chinese Academy of Medical Sciences, Chengdu, People’s Republic of China; 2Department of Anesthesiology, Karamay Hospital of Integrated Traditional Chinese and Western Medicine, Karamay, People’s Republic of China; 3West China School of Medicine, Sichuan University, Chengdu, People’s Republic of China; 4Department of Anesthesiology, Children’s Hospital of Fudan University, Fudan University, Shanghai, People’s Republic of ChinaCorrespondence: Yun Shi, Department of Anesthesiology, Children’s Hospital of Fudan University, Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, 201102, People’s Republic of China, Email [email protected]: Inadvertent intraoperative hypothermia (IIH) is generally associated with several postoperative complications. Inspite of the existing guidelines, the global incidence of IIH remains unacceptably high. Understanding the conditions that influence temperature management is critical for developing future interventions to improve the postoperative patient outcomes. This study aimed to identify the major factors that hinder the implementation of IIH prevention practices.Methods: Through a literature research, pilot small-sample investigation, and expert suggestions, 11 factors that may hinder the implementation of IIH prevention practices were identified. A questionnaire was developed, and each question was used to assess each factor. After approval by the Research Ethics Board, the questionnaires were sent to the staff anaesthesiologists at two academic hospitals via WeChat. Each answer was coded according to the degree to which the factor was affected, as anticipated. Finally, the answers were analysed based on the 80/20 rule to identify the major barriers to effective temperature management.Results: We included 195 participants. Knowledge, memory, attention and decision processes, beliefs about consequences, and environmental context and resources were the major factors, with cumulative composition ratios of 24%, 43.4%, 57.7%, and 70.7%, respectively. Meanwhile, behavioural regulation and social influence were the secondary factors, with cumulative composition ratios of 80.4% and 87.5%, respectively. Reinforcement, confidence in capacity, duty realisation, skills, and intention were the general factors with cumulative composition ratios of 94.3%, 99.8%, 100%, 100%, and 100%, respectively.Conclusion: Four factors–knowledge, memory, attention and decision process, beliefs about consequences, and environmental context and resources–were the major factors that influence the effective hypothermia prevention practice.Relevance to Clinical Practice: These major factors will be used in further studies as a basis to develop the corresponding solutions and improve the patient outcomes in clinical practice.Keywords: intraoperative hypothermia, body temperature, temperature management, 80/20 rule

Keywords

• intraoperative hypothermia
• body temperature
• temperature management
• 80/20 rule