Title:
Reduction of Neonatal Hypothermia by PDSA: A Quality Improvement Initiative in Neonatal Practice

Authors:
Sharmin Afroze, Md. Saddam Hossain, Ankur Sooden, Abrar Wahab, Mohammad Hafijul Islam, Mahmuda Shayema Khorshed, Shamina Sharmin, Ziaul Matin, Bangladesh

Abstract:

Background: Neonatal hypothermia is a commonly encountered problem in newborns and can eventually leads to death if not recognized and managed timely. In a resource limited country like Bangladesh where most of the hospitals are overburdened, hypothermia in newborn is often a missed issue.
Objective: Before the study in Phulbari Upazilla Health complex, 39% of babies were found hypothermic after 1 hour of life which can be detrimental for newborn health. so we aimed to reduce this hypothermia from a baseline of 39% to 0% among all live newborns at first one hour of life.
Method: PDSA (Plan-do-study-act) a four staged quality improvement approach was undertaken for the first time to solve this problem. We oriented the working staffs about PDSA and used concept of warm chain (covering the baby, providing skin to skin contact, delayed weight measurement etc.) to reduce hypothermia; one by one interventions after identifying the gaps and testing the changes.
Results: During the study period 42 newborns were born. By implementing PDSA, the incidence of neonatal hypothermia was reduced to 0% from baseline.
Conclusion: Small Quality improvement projects can bring big changes in practice and can reduce incidence of serious neonatal conditions like hypothermia in first one hour of life.