Perioperative temperature monitoring for patient safety: A period prevalence study of five hospitals

Evaluation of different body temperature measurement methods for patients in the intraoperative period

OBJECTIVES

this study aimed at estimating and comparing the reliability of temperature measurements obtained using a peripheral infrared temporal thermometer, a central cutaneous thermometer ("Zero-Heat-Flux Cutaneous thermometer") and an esophageal or nasopharyngeal thermometer among elective surgical patients in the intraoperative period.

METHOD

a longitudinal study with repeated measures carried out by convenience sampling of 99 patients, aged at least 18 years old, undergoing elective abdominal cancer surgeries, with anesthesia lasting at least one hour, with each patient having their temperature measured by all three methods.

RESULTS

the intraclass correlation coefficient showed a low correlation between the measurements using the peripheral temporal thermometer and the central cutaneous (0.0324) and esophageal/nasopharyngeal (-0.138) thermometers. There was a high correlation (0.744) between the central thermometers evaluated.

CONCLUSION

the data from the current study do not recommend using infrared temporal thermometers as a strategy for measuring the body temperature of patients undergoing anesthetic-surgical procedures. Central cutaneous thermometers and esophageal/nasopharyngeal thermometers are equivalent for detecting intraoperative hypothermia.

Patient-centered precision care in anaesthesia - the PC-square (PC) 2 approach

PURPOSE OF REVIEW

This review navigates the landscape of precision anaesthesia, emphasising tailored and individualized approaches to anaesthetic administration. The aim is to elucidate precision medicine principles, applications, and potential advancements in anaesthesia. The review focuses on the current state, challenges, and transformative opportunities in precision anaesthesia.

RECENT FINDINGS

The review explores evidence supporting precision anaesthesia, drawing insights from neuroscientific fields. It probes the correlation between high-dose intraoperative opioids and increased postoperative consumption, highlighting how precision anaesthesia, especially through initiatives like Safe Brain Initiative (SBI), could address these issues. The SBI represents multidisciplinary collaboration in perioperative care. SBI fosters effective communication among surgical teams, anaesthesiologists, and other medical professionals.

SUMMARY

Precision anaesthesia tailors care to individual patients, incorporating genomic insights, personalised drug regimens, and advanced monitoring techniques. From EEG to cerebral/somatic oximetry, these methods enhance precision. Standardised reporting, patient-reported outcomes, and continuous quality improvement, alongside initiatives like SBI, contribute to improved patient outcomes. Precision anaesthesia, underpinned by collaborative programs, emerges as a promising avenue for enhancing perioperative care.

Perioperative Health Care Professionals' Knowledge of Evidence-Based Inadvertent Perioperative Hypothermia Management

PURPOSE

To evaluate the perioperative health care professionals' knowledge of evidence-based inadvertent perioperative hypothermia management.

DESIGN

A descriptive, cross-sectional study.

METHODS

The research sample consisted of 219 perioperative nurses and anesthesia technicians working in the university hospital and participating in perioperative care. Data were collected by the researchers using a questionnaire that included descriptive characteristics of health care professionals and inadvertent perioperative hypothermia management between March and April 2021. Descriptive statistics, Shapiro-Wilk normality, Kruskal Wallis, Mann Whitney U, and Spearman correlation test were used to analyze the data.

FINDINGS

In this study, only 29.2% of the health care professionals knew that the threshold value for inadvertent perioperative hypothermia was <36 °C. The mean knowledge score of health care professionals on the management of inadvertent perioperative hypothermia was 13.78 ± 3.47. The knowledge score of 79.5% of health care professionals was moderate level. A significant correlation was determined between inadvertent perioperative hypothermia management knowledge score and education status (P = .032), task (P < .001), and mean years in the profession (P = .02).

CONCLUSIONS

The knowledge of the health care professionals working in the perioperative process about evidence-based practices related to inadvertent perioperative hypothermia management was determined to be moderate. We recommend increasing the level of knowledge of health care professionals by providing education on guidelines regarding inadvertent perioperative hypothermia management.

Perioperative hypothermia prevention: development of simple principles and practice recommendations using a multidisciplinary consensus-based approach

OBJECTIVES

To develop a consensus on evidence-based principles and recommendations for perioperative hypothermia prevention in the Australian context.

DESIGN

This study was informed by CAN-IMPLEMENT using the ADAPTE process: (1) formation of a multidisciplinary development team; (2) systematic search process identifying existing guidance for perioperative hypothermia prevention; (3) appraisal using the AGREE II Rigor of Development domain; (4) extraction of recommendations from guidelines meeting a quality threshold using the AGREE-REX tool; (5) review of draft principles and recommendations by multidisciplinary clinicians nationally and (6) subsequent round of discussion, drafting, reflection and revision by the original panel member team.

SETTING

Australian perioperative departments.

PARTICIPANTS

Registered nurses, anaesthetists, surgeons and anaesthetic allied health practitioners.

RESULTS

A total of 23 papers (12 guidelines, 6 evidence summaries, 3 standards, 1 best practice sheet and 1 evidence-based bundle) formed the evidence base. After evidence synthesis and development of draft recommendations, 219 perioperative clinicians provided feedback. Following refinement, three simple principles for perioperative hypothermia prevention were developed with supporting practice recommendations: (1) actively monitor core temperature for all patients at all times; (2) warm actively to keep body temperature above 36°C and patients comfortable and (3) minimise exposure to cold at all stages of perioperative care.

CONCLUSION

This consensus process has generated principles and practice recommendations for hypothermia prevention that are ready for implementation with local adaptation. Further evaluation will be undertaken in a large-scale implementation trial across Australian hospitals.