Implementation of a National Practice Guideline for Maintaining a Neutral Thermal Environment in Preterm Infants at an Academic Medical Center

Background/Significance: Thermal management is a cornerstone of care within the neonatal population. Technology has progressed from a relatively simple incubator to one that is fully automated and designed to keep a neonate warm while maintaining a neutral thermal environment. If used correctly and to their full capacity, these advanced incubators provide improved temperature regulation to support neonatal growth and reduce morbidities.
Purpose: The purpose of this evidence-based practice initiative is to reduce variability and create standardization of the use of the servo control thermoregulation function for infants less than 32 weeks gestation.
Methods: The Iowa Model-Revised (2017) was the framework for implementing this project. The National Association of Neonatal Nurses (NANN) guideline for thermoregulation in the NICU was utilized to educate NICU RN staff regarding thermoregulation and the use of the incubator servo control mode. Chart audits of infants meeting criteria for servo mode were conducted pre and post the education sessions (Time 1 and Time 2).
Results: There was improved compliance with set temperature point from 53.3% to 86.6%. Alternative sites for probe placement were utilized by the staff to include the axilla. Documentation in the EHR improved with additional rationale added when appropriate, reflecting nurses understanding of the education provided and the incorporation of key points into their practice.
Implications for Practice: Utilizing established practice guidelines can facilitate education and optimize nursing practice.

Key Words: thermoregulation, neonatal, servocontrol, temperature control, preterm