A clinical audit cycle of post-operative hypothermia in dogs.

Abstract

OBJECTIVES: Use of clinical audits to assess and improve perioperative hypothermia management in client-owned dogs. METHODS: Two clinical audits were performed. In Audit 1 data were collected to determine the incidence and duration of perioperative hypothermia (defined as rectal temperatures <37&#xb7;0&#xb0;C). The results from Audit 1 were used to reach consensus on changes to be implemented to improve temperature management, including re-defining hypothermia as rectal temperature <37&#xb7;5&#xb0;C. Audit 2 was performed after 1 month with changes in place. RESULTS: Audit 1 revealed a high incidence of post-operative hypothermia (88&#xb7;0%) and prolonged time periods (7&#xb7;5 hours) to reach normothermia. Consensus changes were to use a forced air warmer on all dogs and measure rectal temperatures hourly post-operatively until temperature &#x2265;37&#xb7;5&#xb0;C. After 1 month with the implemented changes, Audit 2 identified a significant reduction in the time to achieve a rectal temperature of &#x2265;37&#xb7;5&#xb0;C, with 75% of dogs achieving this goal by 3&#xb7;5 hours. The incidence of hypothermia at tracheal extubation remained high in Audit 2 (97&#xb7;3% with a rectal temperature <37&#xb7;5&#xb0;C). CLINICAL SIGNIFICANCE: Post-operative hypothermia was improved through simple changes in practice, showing that clinical audit is a useful tool for monitoring post-operative hypothermia and improving patient care. Overall management of perioperative hypothermia could be further improved with earlier intervention.