Raising the temperature in the operating room to prevent hypothermia in burn patients has been a common practice for many years at Loyola University Health System in Maywood, Ill. But Sharon Valtman, BSN, RN, CNOR, a team leader in the operating room for 21 years, wondered if more could be done.
So last year she suggested to Richard Gamelli, MD, FACS, medical director of the hospitals burn unit, that burn patients be warmed an hour or more before scheduled surgery, using a device formerly used only in the operating room. Called the Bair Hugger, the device carries warm air through a hose to a blanket draped over the patient.
Gamelli agreed and asked Julie Liberio, MSN, RN, staff nurse and clinical educator, to create a pre-operative protocol for burn patients.
Liberio spoke with Valtman and established the protocol in March 2013 that all patients in the burn unit undergoing surgery be pre-warmed with the Bair Hugger.
Studies have shown keeping a patient warm during surgery results in faster recovery, according to Jeanne Keane, MSN, RN, nurse manager of the recovery room, surgical admitting center, pre-op and surgical transitional unit. Valtman added the warmer the patients are, the less they bleed in the OR.
When patients body temperatures lower, they burn energy and calories and their blood vessels can become constricted, which affects healing, Liberio said. Its important for the patient to have a normal body temperature, she said.
Burn patients are especially prone to body temperature lowering, which can lead to hypothermia, Valtman said.
The skin is the largest organ of the body and these patients are missing skin due to their burn injuries, she said. They often are shivering when they enter and exit the OR. I wanted the patient to have a temperature that was at least normal when they came into the room, and try to maintain that. Hearing the patients talk of being cold, seeing them uncomfortable, shivering, I wanted them to be able to have that comfort measure before they came into the operating room.
This is a great nurses initiative, Keane said. Sharon and the burn team really thought beyond the operating room, and what we can do for our patients safety and to make their experience better overall.
Liberio said the patients in the burn unit now are warmer when they return from surgery compared with before the pre-warming was done. That promotes better wound healing and a quicker recovery time, she said.
Liberio praised the critical thinking skills of the nurses in working with physicians to help create the new protocol.
Its our job as nurses to listen to our patients and identify ways to ease their discomfort and prevent future health issues, Valtman said.
Sheryl DeVore is a copy editor at Nurse.com.