There's plenty of research that shows the clinical risks associated
with not adequately warming patients. We wanted to know if pre-
warming patients helps keep them normothermic during and after
surgery. That's what we set out to measure with our small, in-house
study that was conducted over a four-week period.
The first thing we did was prewarm patients for 30 minutes in cot-
ton blankets warmed to 130°F. To be clear, we would have loved to
use active warming measures in pre-op, but our budget couldn't han-
dle the investment. We instead opted for the warmed blankets
because our hospital already owned two refrigerator-sized warming
units, and they were at our disposal.
During the intra-op phase, we used forced-air warming, warmed IV
fluids and warmed irrigation fluid (at the time of surgical site irriga-
tion). Warmed blankets were draped on patients during transport to
the PACU.
We took and documented patients' temperatures in pre-op, when
they entered the OR and PACU, and 30 minutes after arrival in recov-
ery. Of the 63 patients included in the study, 20% were hypothermic in
pre-op, 32% in the OR, 41% in PACU and 7% after 30 minutes in recov-
ery. These percentages were all well below 70%, the national average
of inadvertent perioperative hypothermia in 2018.
In the end, we saw $2.35 million in potential savings from the study.
We analyzed the previous year's patient data (2017) and compared it
to the time period we measured for our study. In 2017, documentation
showed a staggering 70% (15,434) of the 22,049 procedures for which
we had data included a hypothermic incident. These incidents cost an
average of $7,000 per case, according to literature review. We applied
the $7,000 figure to the 15,434 cases with hypothermic incidents and
added it to the savings realized by shorter lengths of stay in our hospi-
tal — reducing hypothermic incidents would save 2.6 days of
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