Background: 

Premature neonates require assisted heating devices for thermoregulation in the neonatal intensive care unit (NICU). Traditional use of a cloth blanket and cloth towels during peripherally inserted central catheter (PICC) placement may hinder heat transfer from the assisted heating mechanisms, increasing the risk for neonatal hypothermia.

Purpose: 

This quality improvement project's goal was to reduce the hypothermia rate in very low birth-weight (VLBW) neonates by replacing cloth blanket/towels with a plastic drape during PICC placement.

Methods: 

The FOCUS-PDSA method was used to implement the intervention (plastic drape) over 3 months, during 58 PICC procedures in a level 3 NICU. A pre-/posttest design was used to evaluate the impact of the intervention on hypothermia rates compared with a baseline cloth group and a concurrent cloth cohort.

Results: 

After the 3-month implementation period, the hypothermia rate for the intervention group was lower than that for the baseline cloth group (5.2% and 11.3%, respectively), but this difference was not statistically significant. Post-PICC hypothermia rates were significantly lower for the intervention group than for the concurrent cloth cohort (P = .004).

Implications for Practice: 

Preliminary evidence demonstrated the plastic drape reduced the hypothermia rate in the NICU for VLBW neonates during PICC placement compared with cloth blanket/towels. A plastic drape shows promise in improving nursing practice by providing improved thermoregulation for premature neonates during PICC placement.

Implications for Research: 

Further research is recommended to replicate findings with larger samples of PICC insertions, using a plastic drape in the operating room and other NICU procedures.

中文翻译：

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在外周插入的中央导管置入过程中，使用塑料布减少早产儿的体温过低

背景： 

早产儿在新生儿重症监护病房 (NICU) 中需要辅助加热设备来调节体温。在外周插入中心导管 (PICC) 放置期间，传统使用布毯和布毛巾可能会阻碍辅助加热机制的热传递，从而增加新生儿体温过低的风险。

目的： 

该质量改进项目的目标是通过在 PICC 放置期间用塑料布替换布毯/毛巾来降低极低出生体重 (VLBW) 新生儿的体温过低发生率。

方法： 

在 3 级 NICU 的 58 次 PICC 手术期间，使用 FOCUS-PDSA 方法在 3 个月内实施干预（塑料布单）。与基线布组和并发布组相比，使用前测/后测设计来评估干预对低温率的影响。

结果： 

3个月实施期后，干预组的低温率低于基线布组（分别为5.2%和11.3%），但差异无统计学意义。干预组的 PICC 后体温过低发生率显着低于同时布组 ( P = .004)。

对实践的影响： 

初步证据表明，与布毯/毛巾相比，塑料布单可降低 NICU 中 VLBW 新生儿在 PICC 放置期间的低温率。通过在 PICC 放置期间为早产新生儿提供更好的体温调节，塑料布单显示出改善护理实践的前景。

对研究的影响： 

建议进一步研究以使用更大的 PICC 插入样本复制结果，在手术室和其他 NICU 程序中使用塑料布。