Reducing hypothermia in newborns admitted to a neonatal care unit in a large academic hospital in New Delhi, India
Neonatal hypothermia is a common and dangerous condition around the world. Seventy (70) percent of neonates born in a large children’s hospital in New Delhi, India and subsequently admitted to the neonatal intensive care unit (NICU) were hypothermic (had a temperature below 36.5°C) on admission.
In July 2016, the hospital formed a team comprised of staff from the labor room, NICU, and auxiliary staff to use quality improvement methods to reduce hypothermia in babies transported to the NICU. The team identified problems related to staff awareness of hypothermia and its dangers, environmental factors and supply issues in the labor room, and challenges with rapidly and safely transferring sick newborns to the NICU and used Plan-Do-Study-Act cycles to test and adapt solutions to these problems.
Within 9 months of starting this quality improvement project, the proportion of neonates who had a healthy, normal body temperature on admission to the NICU increased from 27% to 75%, the number of cases of late-onset neonatal sepsis decreased from 15.2 to 5 cases/1000 patient days, and all-cause mortality fell from 4.2 to 2.6 neonatal deaths per week.