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Improving thermoregulation in transported preterm infants: a quality improvement initiative



Increase the percentage of transported preterm or LBW infants with an admission temperature of 36.5–37.5 °C from 60 to 80% by December 2017.

Study design

We used the Model for Improvement with Plan-Do-Study-Act (PDSA) cycles. Interventions focused on awareness of temperature control in preterm infants, adequate monitoring, and maintaining normothermia. Interventions consisted of standardizing isolette temperature, use of chemical warming pack and plastic wrap, and feedback. Data were plotted on a p-chart and grouped by month.


A total of 381 infants <37 weeks or <2.5 kg were transported from January 2016 to December 2019. At baseline 60% were admitted with a temperature within the range of 36.5–37.5 °C. Special cause variation was noted twice during the study period, initially to 80% in June 2018 and then to 96% in April 2019, without an increase in hyperthermia.


Multidisciplinary quality improvement efforts improved normothermia in vulnerable transported infants to 96%.

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We acknowledge the critical care transport team members who were essential to this quality improvement effort, as well as the NICU staff who supported the project. We also acknowledge the caregivers at outlying hospitals who contributed to improvement efforts in thermoregulation for preterm infants prior to the arrival of the critical care transport team. We especially acknowledge the crucial work of Dr. Melanie Stempowski, MD; Deb Skoglund, RN, MSN; Susan Dornan, RN; and Dr. Ganga Srinivas, MD; in actualizing the interventions within the context of individual hospitals.


Support for REDCap (Research Electronic Data Capture) Provided by: CTSC grant (1 UL1 RR024989 from NCRR/NIH)

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Authors and Affiliations



TG conceptualized the project, collected data, planned interventions, evaluated the success of each PDSA cycle, and drafted and revised the final manuscript. RP assisted with implementing interventions, providing feedback on each intervention, evaluated all data points outside of goal range, and revised the final manuscript. LC assisted with data collection, planning and assessing interventions, and revised the final manuscript. GY supervised the project, assisted with planning the initial project, assisted with planning and assessing interventions, and revised the final manuscript.

Corresponding author

Correspondence to Tara Glenn.

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The authors declare that they have no conflict of interest.

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Glenn, T., Price, R., Culbertson, L. et al. Improving thermoregulation in transported preterm infants: a quality improvement initiative. J Perinatol 41, 339–345 (2021).

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