WIP 18 - A Quality Improvement Approach on Reducing Admission Hypothermia to the NICU in a tertiary center Addis Ababa, Ethiopia

Publication Number: WIP 18.7629

Kullehe Haddis Yeshanew, Tikur Anbessa Specialized Hospital, Addis Ababa University, Addis Ababa, Adis Abeba, Ethiopia; Asrat Demtse. Gebremedhin, Tikur Anbessa Spescialized Hospital, AAU, Addis Ababa, Adis Abeba, Ethiopia; MAHLET ABAYNEH GIZAW, St Paul's Hospital Millennium Medical College, Addis Ababa, Adis Abeba, Ethiopia; Firehiwot M. Mekuria, Tikur Anbessa Specialized Hospital, Addis Ababa University, Addis Ababa, Adis Abeba, Ethiopia; YAFET Noah WOLDESELASSIE, Addis Ababa university college of health science tikur anbessa specialized hospital, Addis Ababa, Adis Abeba, Ethiopia; ABRHAM MANAWKO YAYEH, Debre birhan universty, Addis aba a, Adis Abeba, Ethiopia; HULUAGERISH ESHETE. WOlde, Tikur Anbessa hospital, ADiSS ABABA, Adis Abeba, Ethiopia; Feyissa Senbato. Regassa, The Ohio State University Global One Health Initiative, Addis Ababa, Adis Abeba, Ethiopia; Hawa A. Dawed, Addis Ababa Universty, Addis Ababa, Adis Abeba, Ethiopia

Background: Neonatal hypothermia is a common global problem with significant morbidity and mortality especially for low & middle income countries like Ethiopia. WHO has proposed warm chain methods to be used but it is not practiced consistently. This study is done in a teaching tertiary hospital in Addis Ababa with an aim to reduce admission hypothermia in the NICU by 50% from the base line.

Objective: We aim to decrease the incidence of admission hypothermia by 50% from the baseline (82% to 41%) in inborn babies of Tikur Anbesssa Hospital in 20 weeks.

Design/Methods: We plan to conduct multiple Plan- Do- Study -Act cycles in order to decrease admission hypothermia in the NICU which was started from August 1,2024 and continues until December 31,2024. The study is being done at Tikur Anbessa Specialized Hospital delivery room and Neonatal Intensive care unit after obtaining an IRB approval from the Department of Pediatrics and Child health. Our QI team consists of Neonatologist, Neonatology fellow, Midwives, NICU nurses,Hospital Metron and a QI officer. The study has a baseline, implementation and sustenance phase.Data is being collected using a questionnaire developed for this purpose. The first 4 weeks were used to collect base line data and identification of key barriers. The weeks from 5-16 are implementation time for change ideas and the last 17-20 weeks will be sustenance phase. All newborns born in the same hospital and then need admission to the Neonatal intensive care unit with in 1 hour of birth will be included in the study. The primary outcome indicator is admission temperature of the newborn at Neonatal Intensive Care Unit while the balancing measure is hyperthermia (>37.50C). The planned interventions are giving refresher training to midwives and nurses on warm chain & essential newborn care, use of warm towels and occlusive hats, increasing delivery room temperatures to greater than 25 0C , Use of skin to skin care for transport. These change ideas will be implemented in three phases of PDSA cycles. The data collected will be interpreted using descriptive statistics.