Surgical Best Practices for Infection Prevention

Maintaining Normothermia

The IHI points out that anesthesia, anxiety, wet-skin preparations and skin exposure in cold operating rooms can cause patients to become clinically hypothermic during surgery. Numerous studies in the medical literature indicate that patients undergoing surgery have a decreased risk of SSI if they are not allowed to become hypothermic during the perioperative period. The IHI’s 5 Million Lives Campaign and SCIP also point to evidence showing that preventing hypothermia is beneficial in reducing other complications, while also being comforting to surgical patients.

“Our poor patients are subjected to varying room temperatures,” Clark says. “Warm for children and neonates and when a trauma patient comes in; cool to cold for most other patients.”

The IHI suggests the following ways to help maintain normothermia:

Prevent hypothermia at all phases of the surgical process

Use warmed forced-air blankets preoperatively, during surgery and in PACU

Use warmed fluids for IVs and flushes in surgical sites and openings

Use warming blankets under patients on the operating table

Use hats and booties on patients perioperatively.

Adjust engineering controls so that operating rooms and patient areas are not permitted to become excessively cold overnight, when many ORs are closed

Measure and monitor temperature with a standard type of thermometer