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Normothermia Clinical Guideline

ASPAN’s Evidence-Based Clinical Practice Guideline for the Promotion of Perioperative Normothermia

Eight years ago, ASPAN published its first clinical practice guideline, designed to guide perianesthesia, perioperative, and anesthesia health care providers in the prevention and/or management of perioperative hypothermia.1  In the eight years since that first publication, ASPAN’s approach to evidence-based practice and clinical practice guideline development has undergone a considerable evolution, resulting in a structured, systematic guideline development process designed to provide the practitioner with the highest strength and quality of evidence available to guide their practice. Although our approach to guideline development has undergone extensive restructuring and improvement, the need for continued development and/or revision of guidelines continues unabated resultant to the unrelenting presentation of significant patient care issues.
 
The adverse effects of perioperative hypothermia have been well documented since the late 1990s. In recognition of these adverse effects and the clinician’s need for guidance regarding temperature and thermoregulation management, ASPAN first convened a multidisciplinary group of experts to develop the first edition of the hypothermia guideline in the late 1990s. Despite publication of these guidelines, however, unplanned perioperative hypothermia continues to present as a significant clinical problem, the magnitude of which is evidenced by the inclusion of normothermia/temperature management infection measures in the Surgical Care Improvement Project (SCIP).2,3 

Given that unplanned perioperative hypothermia remains a proven contributor to perianesthesia/perioperative patient adverse outcomes, ASPAN convened a multidisciplinary Strategic Work Team (SWT) to revise the 2001 hypothermia guideline for current practice. The team consisted of 12 multidisciplinary, multispecialty experts that included representatives from ASPAN, the American Association of Nurse Anesthetists (AANA), the American Society of Anesthesiologists (ASA), and the Association of periOperative Nurses (AORN). This prestigious group met in October of 2008 in Kansas City, Missouri, with the specific aim of developing consensus-based, multimodal practice recommendations gleaned from and supported by the strongest levels and quality of evidence available. The resulting evidence-based clinical practice guideline was open for public review and commentary before endorsement by the ASPAN Representative Assembly on April 19, 2009. Endorsements from AANA, ASA, and AORN are pending.

This guideline is intended to serve as a practical bedside tool for anesthesia providers and perianesthesia/perioperative nurses in the promotion of perioperative normothermia. The goal of this guideline is to provide recommendations for both nursing and medical assessment and intervention designed to optimize patient outcomes. The guideline is also designed to promote collaboration, communication, and a true team approach across all disciplines in patient management across the surgical continuum.

ASPAN is proud to present this critical tool for the advancement of evidence-based, safe, quality patient care. It is our hope that this guideline will promote improved patient assessment, management, and satisfaction with care.  Most importantly, it is our hope that this guideline will contribute to improved patient safety and optimal patient outcomes. We also hope that this guideline will spur future research into all areas of perioperative thermoregulation and normothermia promotion, as well as research evaluating the effect of guideline recommendations on patient outcomes. 

References

  1. American Society of PeriAnesthesia Nurses. Clinical guideline for the prevention of unplanned perioperative hypothermia. J Perianesth Nurs. 2001;16:305-314.
  2. QualityNet. SCIP measures: Infection. Available at: http://www.qualitynet.org/dcs/ContentServer?level3=Measures&c=MQParents&pagename=Medqic%2FMeasure%2FMeasuresHome&cid=1089815967030&parentName=Topic. Accessed September 12, 2009.
  3. Surgical Care Improvement Project. Fact sheet: Summary of SCIP measure changes for 10/1/09 + discharges. Available at: http://www.qualitynet.org/dcs/ContentServer?c=OtherResource&pagename=Medqic%2FOtherResource%2FOtherResourcesTemplate&cid=1220993717210. Accessed September 12, 2009.

Click here to read the ASPAN Normothermia Clinical Guideline (pdf)

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