Development of a warming Care Protocol to Prevent Hypothermia and Shivering in Pregnant Woman Undergoing Elective Cesarean Section with Spinal Anesthesia

Abstract

                                                                                                        Abstract

     This research and development aimed to study the situation, develop guidelines and effectiveness of body warming methods to Prevent Hypothermia and Shivering in Pregnant Woman Undergoing Elective Cesarean Section with Spinal Anesthesia. This study consisted of 3 steps. First step explored the situation, problems and needs of anesthetists using document analysis and qualitative methods from 15 anesthetists. Content analysis were applyied. Step 2 was develop a warm-up guideline by lifting the draft before sending it to 3 experts for review, revising and creating a manual. The last step evaluated the effectiveness by using the quasi-experimental research method with a two-group pre- and post-test design. The sample consisted of 40 women who underwent emergency cesarean section. Data were analyzed using descriptive statistics, Independent t-test, Mann-Whitney U-test, Linear Mixed Effects Model, Chi-square test and One-sample t-test. The research results found that:

1. The incidence of shivering during 2021-2024 was expected to increase by 29%, 40.74% and 45.18%, respectively. The problems for anesthesia nurses in caring for this group of patients are the lack of clear care guidelines, insufficient warming equipment, longer care time in the recovery room, overcrowding, and inadequate care.


2. Clinical practice guidelines for warming up to prevent hypothermia and shivering include three phases. Preoperative, intraoperative and postoperative periods by providing warmth at all stages and treating chills and monitoring for complications.


3.  Comparison of body temperature at the time of patient entering the operating room, 15 minutes after spinal anesthesia injection, at the time of patient arrival in the recovery room and before discharge from the recovery room had statistically significant differences (p-value < 001). Moreover, the results of the comparison of chills in patients entering the operating room after spinal anesthesia injection for 15 minutes, patients arriving in the recovery room, and before discharge from the recovery room showed statistically significant differences (p-value < 0.001). Furthermore, anesthesia nurses' satisfaction with the practice guidelines was significantly higher than the 80% (p-value < 0.001)   

    Keywords : warming protocol,spinal anesthesis,cesarean section,shivering,hypothermia