AB097. SOH24AB_039. Intra-operative temperature monitoring: an audit of compliance to the national standard at University Hospital Limerick

Background: Core temperature monitoring is appropriate to facilitate detection of malignant hyperthermia and hypothermia. Intra-operative hypothermia (core temperature 36 ℃) is associated with surgical wound infections, coagulopathy and prolonged hospitalisation1. The Association of Anaesthetists guidelines for the standards of monitoring during anaesthesia and recovery recommend recording temperature before anaesthesia and every 30 minutes until the end of surgery. An audit assessing compliance to intra-operative temperature monitoring was conducted in a university hospital.

Methods: Patient anaesthetic charts were reviewed over a three-week period. Adult patients undergoing general, neuroaxial and regional anaesthesia, lasting 30 minutes or more, were included in data collection. Temperatures at induction, intra-operatively and in recovery were recorded. Patient demographics, type of operation, type of anaesthesia and active rewarming techniques were also recorded.

Results: A total of 50 anaesthetic charts were included for data analysis. Temperature was documented at induction and every 30 minutes thereafter, in 15 cases, setting compliance at 30%. Twenty-five/42 (59%) patients were identified as hypothermic in recovery, only 8/25 (32%) patients in this hypothermic cohort had temperature recorded intraoperatively. Forty-three/50 (86%) patients received active rewarming with warm fluids or a warming blanket. A root cause analysis was performed; staff knowledge, equipment and lack of documentation were factors identified as potential barriers for compliance.

Conclusions: Compliance to intra-operative temperature monitoring was low in this department. A quality improvement initiative including an educational session to relevant staff was performed. Non-invasive transcutaneous thermometers were also introduced as a pilot to improve compliance. A re-audit will be performed in four weeks to assess compliance following these interventions.

Keywords: Peri-operative; temperature monitoring; intraoperative temperature monitoring; anaesthesia; hypothermia