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Occlusive Bags to Prevent Hypothermia in Premature Infants: A Quality Improvement Initiative

Godfrey, Kathleen DNP, NNP-BC, CPNP; Nativio, Donna G. PhD, CRNP, FAAN; Bender, Charles V. MD; Schlenk, Elizabeth A. PhD, RN

Section Editor(s): Ikuta, Linda

doi: 10.1097/ANC.0b013e31828d040a
Foundations in Newborn Care

The aim of this quality improvement initiative was to improve the neonatal intensive care unit (NICU) admission rectal temperatures of premature infants less than 28 weeks' gestation by placing them in an occlusive bag from the neck down immediately after birth. The historical control group consisted of a convenience sample of 46 very low-birth-weight infants from March 1, 2010, to August 31, 2010. A convenience sample of 35 very low-birth-weight infants from October 1, 2010, to April 30, 2011, was recruited during the prospective phase. A quasi-experimental design was used. A retrospective medical record review was performed to collect data on NICU admission rectal temperatures for the historical control group. During the prospective phase, infants were placed in a bag from the neck down immediately after birth and NICU admission rectal temperatures were recorded. In both groups, NICU rectal temperatures were measured immediately upon admission. Application of the bag resulted in a higher mean NICU admission rectal temperature in the intervention group compared with the historical control group. Occlusive bags applied at delivery decreased heat loss in premature infants. The results support previous findings and resulted in a change in clinical practice.

Department of Health Promotion and Development, University of Pittsburgh School of Nursing (Drs Godfrey and Nativio); Department of Pediatrics and Obstetrics and Gynecology, University of Pittsburgh School of Medicine (Dr Bender); and Department of Health and Community Systems, University of Pittsburgh School of Nursing (Dr Schlenk), Pennsylvania.

Correspondence: Kathleen Godfrey, DNP, NNP-BC, CPNP, School of Nursing, University of Pittsburgh, 3500 Victoria St, Room 440, Pittsburgh, PA 15261 (

This quality improvement initiative was conducted at the University of Pittsburgh School of Nursing and Magee-Womens Hospital of University of Pittsburgh Medical Center, Pennsylvania. This quality improvement initiative was supported in part by a grant from the Leslie A. Hoffman Endowed Research Award.

The authors thank Mary Kish, DNP, NNP-BC, who assisted with neonatal intensive care unit staff education and data collection.

The authors declare no conflict of interest.

© 2013 by The National Association of Neonatal Nurses