Documentation of Core Temperature in Pediatric Patients Undergoing General Anesthesia: A Quality Improvement Initiative to Increase Compliance.

BACKGROUND

Children's body composition makes them highly susceptible to heat loss, which is further amplified by anesthetic-induced inhibition of thermoregulatory control. Perioperative hypothermia can lead to adverse outcomes, thus highlighting the importance of core temperature monitoring for pediatric patients undergoing general anesthesia. We launched and completed a quality improvement (QI) initiative at our institution starting in February 2023, with the SMART aim to increase the percentage of pediatric patients in our dental OR who receive a documented core temperature in the anesthetic record from 10% to 60% by October 2023.

METHODS

We referenced the Standards for Quality Improvement Reporting Excellence guidelines and used the Model for Improvement with interventions tested via Plan-Do-Study-Act cycles. We tested 5 interventions between February and October 2023. These included an educational email to all anesthesia professionals, a posted sign in the OR, a Morbidity and Mortality Conference regarding core temperature monitoring, and the development of an integrated pop-up reminder to measure core temperature in our electronic healthcare record.

RESULTS

With this QI initiative, the percentage of pediatric patients undergoing general anesthesia for more than an hour in our dental OR with documented core temperature monitoring increased from 10% to 60% by October 2023, and to 90% by January 2024.

CONCLUSIONS

We successfully increased compliance with standard ASA monitoring guidelines. By January 2024, 90% of pediatric patients undergoing general anesthesia for more than an hour in our dental OR had documented core temperature monitoring in the anesthetic record.