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Abstract

This DNP scholarly project was implemented to evaluate the impact of prewarming on the incidence of inadvertent perioperative hypothermia (IPH) in adult patients undergoing surgical hip procedures (SHP) with combined sedation and neuraxial anesthesia. IPH affects up to 90% of surgical patients across the United States every year. The adverse effects of IPH include increased mortality, cardiac events related to shivering, poor blood clotting, poor wound healing, decreased patient satisfaction and increased cost for the patient and the surgical facility. A pretest and posttest was used to measure of the effects of prewarming on the incidence of IPH during the perioperative period. Fifty-six patients were selected by a convenience sample and randomized with computer generated randomization. Twenty-eight patients were selected from the randomized sample and matched to a comparison group that did not receive prewarming. Matching was based on body mass index (BMI), gender, age and, surgical procedure. Descriptive statistics were reported. The paired t-test was utilized for the analysis of continuous data and the McNamar's test was utilized for analysis of categorical data between the implementation and comparison groups. Twenty-eight paired subjects (n = 56) consisting of one subject in the implementation group and 1 subject in the comparison group were divided into 4 groups for analysis.* Group 1: Hypothermia occurred in both implementation and comparison groups.* Group 2: Hypothermia occurred in neither implementation nor comparison group.* Group 3: Hypothermia occurred in the implementation group only, (The implementation subject became hypothermic but the matched comparison subject did not).* Group 4: Hypothermia occurred in comparison group only. The results were statistically significant for the intraoperative phase with a p-value of <0.001 (McNemar's test). There was no statistically significant differences found between the groups for postoperative care unit length of stay (p = 0.841). This project supports current literature that prewarming patients prior to surgical procedures reduces the incidence of IPH.

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