Targeted Temperature Management Protocol in a Pediatric Intensive Care Unit: A Quality Improvement Project.
Background: In patients with acute neurological injury, abrupt temperature change exacerbates increased intracranial pressures and negatively affects perfusion pressure and cerebral blood flow. Critical care nurses must provide coordinated and effective interventions to maintain normothermia without...
| Publicado en: | Critical Care Nurse Vol. 41; no. 5; pp. 41 - 51 |
|---|---|
| Autores principales: | , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
American Association of Critical-Care Nurses
Oct2021
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=152736771&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 152736771 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 02795442 1GD jtl: Critical Care Nurse issn: 02795442 maglogo: N pubinfo: dt: Oct2021 vid: 41 iid: 5 pid: 2559 pub: American Association of Critical-Care Nurses place: Alisa Veijo, California artinfo: ui: 152736771 152736771 152736771 10.4037/ccn2021554 152736771 ppf: 41 ppct: 10 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Targeted Temperature Management Protocol in a Pediatric Intensive Care Unit: A Quality Improvement Project. aug: au: Prendergast, Erica Allen, Kiona Y. Mills, Michele Grimason Moran, Thomas Harris, Z. Leah Malakooti, Marcelo Smith, Craig M. Wainwright, Mark S. McCarthy-Kowols, Maureen affil: Erica Prendergast is a neurocritical care nurse practitioner, Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois sug: subj: Quality Improvement Evaluation Intensive Care Units, Pediatric Hyperthermia Therapy Brain Diseases Clinical Effectiveness Human Electronic Health Records Retrospective Design Tertiary Health Care Scales Algorithms Fisher's Exact Test ab: Background: In patients with acute neurological injury, abrupt temperature change exacerbates increased intracranial pressures and negatively affects perfusion pressure and cerebral blood flow. Critical care nurses must provide coordinated and effective interventions to maintain normothermia without precipitating shivering immediately after acute neurological injury in pediatric patients. Objective: To improve hyperthermia management in a 40-bed pediatric intensive care unit, an interdisciplinary pediatric critical care team developed, implemented, and evaluated a targeted temperature management protocol. Methods: The project was guided by the organization's plan-do-study-act quality improvement process. Quality improvement was assessed retrospectively using electronic medical records of patients meeting eligibility criteria. Samples of pediatric patients who received temperature interventions were compared before and after protocol implementation. The protocol included environmental, pharmacological, and body surface cooling device interventions, as well as use of a bedside shivering assessment scale and stepwise interventions to prevent and control shivering. Results: Before implementation of the targeted temperature management protocol, 64% of patients had documented temperatures higher than 37.5 °C, and body surface cooling devices were used in 10% of patients. After protocol implementation, more than 80% of patients had documented temperatures higher than 37.5 °C, and body surface cooling devices were used in 62% of patients. Four patients (6%) before and 5 patients (31%) after protocol implementation were treated with body surface cooling without requiring use of neuromuscular blockade. Conclusions: Creation and implementation of a targeted temperature management protocol increased nurses' documented use of body surface cooling to manage hyperthermia in pediatric intensive care unit patients with acute neurological injury. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|