Survey on knowledge and practice of intraoperative temperature management

• Main Authors: Md Ralib, Azrina, Mohd Saufian, NorAisyatul Azni, Kamarudin, Norhidayah, Lukman, Mohd Fahmi, Mohamed, Abdul Hadi, Mohd Rus, Razman
• Format: Conference or Workshop Item
• Language: English
• Published: 2010
• Subjects: R Medicine (General)
• Online Access: http://irep.iium.edu.my/37390/1/4._ACCA_Hypothermia.pdf; http://irep.iium.edu.my/37390/

PURPOSE OF STUDY Intraoperative temperature monitoring and management is critically important to prevent complications associated with hypothermia. Satisfactory knowledge and practice in this area amongst the clinicians who are managing the patients intraoperatively is of utmost important to prevent development of hypothermia and its subsequent complications. METHODS USED This study was conducted in two phases in two hospitals. The first phase was conducted to investigate the level of knowledge and practice in this area among clinicians at the Anaesthesia Department. The second phase was performed to determine the incidence of intraoperative hypothermia and its associated risk factors at the two hospitals. The data were analyzed using single proportion, single mean, chi-square, independent t-test, bivariate analysis, linear regression and multiple linear regressions. SUMMARY OF RESULTS Overall mean knowledge score was 56.91% (SD 16.50), with no significant difference between the two hospitals (p=0.826). 44.7% of respondents had acceptable satisfactory score of knowledge. Overall mean practice score was 77.66% (SD 16.05), with no significant difference between HSNZ and HTAA (p=0.164). However, only 19.1% of respondents had acceptable satisfactory score of practice. There was a weak correlation (r=0.186) between mean knowledge score (56.91%) and mean practice score (77.66%). The weakest area on knowledge and practice were sites for peripheral temperature monitoring (10.6%) and temperature monitoring during RA (19.1%). In the second phase of the study, 43.4% of patients developed mild and moderate hypothermia at the end of operation. There was a significantly higher percentage of development of mild and moderate hypothermia at 1,2 and 3 hour at HSNZ compared to HTAA. There were significant association in the development of hypothermia between different type of surgery at 1 hour (p=0.01) and 2 hours (p=0.01), but not at 3 hours. On the other hand, there was no significant association in the development of hypothermia between different type of anaesthesia. There was no significant correlation between patients’ temperature with patients’ age, OT temperature, OT humidity and amount of blood and fluid transfusion at 1 hour (r=0.26, p=0.48), 2 hours (r=0.28, p=0.78), and 3 hours (r=0.89, p=0.69). CONCLUSION These findings showed that knowledge and practice of intraoperative temperature monitoring and management was still poor amongst clinicians in these hospitals. 44.7% achieved acceptable standard of knowledge, however only 19.1% achieved acceptable standard of practice. Furthermore, there was poor correlation between knowledge and practice possibility due to other factors such as availability of temperature monitoring and warming devices. This probably influences the high prevalence of hypothermia in both hospitals. 43.4% developed either mild or moderate hypothermia at the end of operation. Correlation between hypothermia and its risk factors could not be demonstrated due to small sample size. Hence it is important to create awareness in this area amongst clinicians to prevent unnecessary complications, especially in high risk patients undergoing surgery associated with strong risk factors