Increasing the use of Blood Warmers in a Level 4 NICU

Background Blood warmers have been proven to be safe and effective in the adult population in preventing hypothermia induced from transfusions. However, using blood warmers for transfusions is not standard practice in the neonate population, except for exchange transfusions. Infusing warm fluids have been effective in maintaining patient's temperature compared to room temperature fluid. Neonates that suffer from hypothermia are at increased risk for respiratory distress, infection, necrotizing enterocolitis, and even death. The purpose of this project is to educate and train NICU staff on the Hotline warmer, as a part of a larger study aimed at investigating impact of blood warmers for the neonatal population.MethodIn this quality improvement project, education was provided to increase staff knowledge on the upcoming blood warmer study and the Hotline warmer. Pre and post surveys evaluated the effectiveness of the education.ResultsThere was minimal response with the pre and post survey. 36 of the 210 staff responded to the pre survey and 19 responded with the post survey. In the presurvey, 57% (n=20) of the staff did not know where the Hotline blood warmer was located and 64% (n=23) of staff had not received previous training. While 61% of staff had previous experience with using a blood warmer, 69% of staff did not feel comfortable setting up the Hotline blood warmer. Post education, 95% (n=18) of staff knew where the location of the Hotline blood warmer was and 72% (n=13) of the staff felt comfortable in setting up the blood warmer. 58% (n=11) of the staff felt additional hands-on training would be beneficial. Comparing the data from the staff that completed both the pre and post survey, there was a 42.1% increase in staff that knew the location of the blood warmer which is statistically significant (p<0.05). There was also a 31.6% increase in the number of staff that felt comfortable setting up the blood warmer which is statistically significant (p<0.05). ConclusionIn preparation for the upcoming in vivo study, education was provided to staff about the Hotline warmer and upcoming study details. The education provided was effective in helping staff know where the blood warmer was located and how to set it up, along with the details of the study. However, an additional hands-on demonstration of the Hotline blood warmer would be appreciated by most of the staff that filled out the surveys, which is planned as a part of phase two to the blood warmer study.