Neonatal PICC placement and prevention of hypothermia
Background: Premature neonates require assisted heating devices for thermoregulation in the neonatal intensive care unit (NICU). Traditional use of a cloth blanket and cloth towels during peripherally inserted central catheter (PICC) placement may hinder heat transfer from the assisted heating mechanisms, increasing the risk for neonatal hypothermia.
Purpose: This quality improvement project’s goal was to reduce the hypothermia rate in very low birth-weight (VLBW) neonates by replacing cloth blanket/towels with a plastic drape during PICC placement.
Methods: The FOCUS-PDSA method was used to implement the intervention (plastic drape) over 3 months, during 58 PICC procedures in a level 3 NICU. A pre-/posttest design was used to evaluate the impact of the intervention on hypothermia rates compared with a baseline cloth group and a concurrent cloth cohort.
Results: After the 3-month implementation period, the hypothermia rate for the intervention group was lower than that for the baseline cloth group (5.2% and 11.3%, respectively), but this difference was not statistically significant. Post-PICC hypothermia rates were significantly lower for the intervention group than for the concurrent cloth cohort (P = .004).
Implications for practice: Preliminary evidence demonstrated the plastic drape reduced the hypothermia rate in the NICU for VLBW neonates during PICC placement compared with cloth blanket/towels. A plastic drape shows promise in improving nursing practice by providing improved thermoregulation for premature neonates during PICC placement.
Implications for research: Further research is recommended to replicate findings with larger samples of PICC insertions, using a plastic drape in the operating room and other NICU procedures.
Phan HKT, McIntyre TM. Using a Plastic Drape to Reduce Hypothermia in Premature Neonates During Peripherally Inserted Central Catheter Placement. Adv Neonatal Care. 2021 Jun 16. doi: 10.1097/ANC.0000000000000906. Epub ahead of print. PMID: 34138792.