Vol. 6, Issue 2, Part D (2024)

Background: Hypothermia in new-born when the body temperature drops below 36.5 °C. Premature infants have higher risk of hypothermia. For each drop in 1 °C of body temperature, mortality rate is increased by 28% & rate of late onset sepsis is increased by 11%. The incidence of hypothermia in Very Low Birth weight (VLBW) infants on admission to NICU ranges between 31 to 78%.

Aims and Objectives: To study the effectiveness of quality improvement interventions in reducing hypothermia in very low birth weight infants on admission to neonatal intensive care unit and to evaluate the outcome of the babies before & after quality improvement at a tertiary care hospital in Southern Rajasthan.

Materials and Methods: This was a Prospective Observational study conducted Tertiary Care hospital. The study included preterm infants below 1500 gm weight born at the Obstetric department of the hospital. The study was done in 2 phases. An Observation phase of 3 months and implementation phase of 6 months (3 cycles).

Results: A total of 100 babies during observation and 200 babies during implementation phase were studied. Mean admission temperature in Plan Do Study Act (PDSA) phase increased significantly to 36.53º C from 35.25ºC in observational phase. The incidence of moderate hypothermia decreased from 69% to 22.37%. Similarly, the incidence of normal temperature increased from 2% to 27.63% (p <0.001). complications like IVH (4% Vs 13%, p < 0.01), Late onset neonatal sepsis (23.5% Vs 41%, p < 0.05) showed significant reduction. Mortality reduced from 23% to 17%.

Conclusion: Quality improvement method using the WHO-POCQI model, is a very cost-effective approach in reducing admission hypothermia at NICU in pre-term babies in a resource limited setting, and further decreasing the morbidity associated with it.