A retrospective Comparison of Hypothermia Proportion Among Newborns Using General Postnatal Nursing Practice versus Baby Warm Practice Guideline

OBJECTIVES: To investigate the proportion of neonatal hypothermia this study compares newborns who received General Postnatal Nursing (GPN) Practice based on previous clinical practice guidelines with those who received Baby Warm Practice (BWP) Guideline based on the latest guidelines for preventive neonatal hypothermia. MATERIALS AND METHODS: : The study sample consisted of newborn medical records of newborns who were delivered at Bangkok Hospital Chiang Mai between May 1, 2016 and April 30, 2018, with gestational age between 37 and 42 weeks, in good health, and with an Apgar score of more than 7. The study was analyzed and the proportion of neonatal hypothermia occurrence between the group that received care according to the GPN practice and the group that received care according to the BWP Guideline were compared. RESULTS: A total of 315 neonates who met the selection criteria and had complete data were included in this research project. They were divided into two groups, BWP Guideline group (n = 157, 49.84%) and GPN Practice group (n =158, 50.16%), according to the predefined criteria. The basic demo- graphic characteristics of the two groups were found to be different. The Apgar score at 1 minute was 8 in 30 neonates (19%) in BWP Guideline group, which was higher than the 15 neonates (9.5%) in GPN Practice group. The Apgar score at 5 minutes was 10 in 100 neonates (63.7%) in BWP Guideline group, which was lower than the 118 neonates (74.7%) in GPN Practice group. The temperature in the delivery room and operating room was less than 22 °C in 89 neonates (56.68%) in BWP Guideline group, which was lower than the 140 neonates (88.6%) in GPN Practice group. The temperature in the transition room was less than 24 °C in 13 neonates (8.28%) in BWP Guideline group, which was lower than the 32 neonates (20.25%) in GPN Practice group. The study found that there were 3 neonates (1.9%) in BWP Guideline group and 7 neonates (4.4%) in GPN Practice group with low body temperature, and there was no significant difference between the two groups (p = 0.336). CONCLUSION: The BWP Guidelines for preventing neonatal hypothermia in newborns have been updated to emphasize continuous warmth provision (The Warm Chain), increasing prevention of heat loss from the newborn’s body, increasing the ambient temperature, and using plastic caps (Baby Warm Cap) to prevent heat loss from newborn’s head. These guidelines result in a lower proportion of neonatal hypothermia compared to the previous guide- lines. Both groups, however, did not differ significantly in the incidence of neonatal hypothermia.