Based on literature reviews, as many as 70 percent of surgical patients develop hypothermia during the perioperative experience. Documented studies demonstrate the association of hypothermia with many significant complications. Hypothermia can begin in the preoperative phase shortly after admission to the preoperative department. Actively warming the preoperative patient for 30 to 60 minutes can decrease the temperature gradient between the periphery and the core and maintain equilibrium of the patient. Decreasing the temperature gradient during the preoperative phase leads to less heat loss during the operative phase. Neuman's systems model of nursing theory exemplifies the importance of prevention in the management and avoidance of stressors to the patient system. Minimizing stressors helps to maintain optimal equilibrium and wellness. The simple and inexpensive nursing intervention of active preoperative warming has been shown to decrease hypothermia during the operative and post anesthesia phases of surgery. Active warming decreases surgical complications, improves patient outcomes, and decreases health care costs. It is also shown to increase patient comfort and decrease anxiety. Considering Neuman's theory, the benefit of comfort and decreased anxiety also leads to equilibrium and better outcomes. Current practices of passive, courteous warming should be changed to intentional interventional warming for the purpose of hypothermia prevention. Standardized preoperative care that includes active warming can improve patient outcomes by decreasing the associated complications of hypothermia.

Inadvertent Perioperative Hypothermia (IPH) is defined as a patient's core body temperature unintentionally dropping below 36°C at any point in the perioperative environment. IPH occurs most frequently in the first hour after induction of general anesthesia secondary to vasodilation and heat transfer from the patient's core to the periphery. Despite well-known detrimental intraoperative and postoperative outcomes associated with IPH, it continues to occur in approximately half of all surgical patients. Literature reviews reveal that promotion of normothermia throughout the perioperative environment reduces the incidence of complications of IPH, improves patient outcomes, and lowers health care costs. Current preoperative practice is to monitor a patient's temperature only once on admission and subsequently deploy passive warming interventions with no further monitoring. Ensuring that patients are appropriately monitored and actively warmed preoperatively has been identified as a strategy to reduce the incidence of IPH both intraoperatively and postoperatively due to maintenance of peripheral temperature and limiting of heat-transfer following general anesthetic onset. As Orem's Self-Care Deficit Theory maintains the nursing role in purposefully assisting patients to meet their self-care needs, known and unknown, actively ensuring euthermia in the preoperative environment promotes optimal outcomes in surgical patients and aligns nurses with the priorities of patient care and patient advocacy. Active intraoperative warming is effective but frequently insufficient to prevent the occurrence of IPH alone. A standardized, intentional preoperative warming strategy which includes continual patient temperature monitoring and purposeful intervention will reduce the incidence of IPH and associated complications.

This practical text offers a comprehensive guide to perioperative temperature management for anaesthetists, surgeons and nurses. The physiological basics of thermoregulation and heat exchange are covered, before the changes that occur during general and regional anaesthesia are outlined. The relevant adverse scenarios associated with perioperative hypothermia, including morbid cardiac events, impairment of coagulation, increased blood loss and surgical site infections are discussed, before the methods of measuring core temperature and the equipment and techniques to keep patients warm are described. Richly illustrated and clearly structured for quick reference, Perioperative Temperature Management is an essential daily resource to help ensure safe, effective practice.

Unplanned perioperative hypothermia (UPH), a common event in the surgical setting, is associated with many adverse patient outcomes. In current perioperative practice, patient core temperature is monitored and active warming interventions are implemented during the intraoperative and postoperative phases in response to UPH. The literature suggests preoperative warming of patients as a proactive measure may be more effective in the prevention of UPH. In the form of an integrative review, this thesis seeks to address the research question: For adult patients undergoing general anesthesia, how does preoperative warming compared to no preoperative warming affect UPH incidence? A database search yields ten studies for inclusion and study findings are synthesized and summarized. The conclusion is drawn there is sufficient evidence to support preoperative warming as an effective measure to decrease UPH incidence and should be considered for implementation in clinical practice as the benefits outweigh the risks.

It is said that anywhere between 60% and 90% of surgical patients will become hypothermic(Hegarty and others, 2009). This paper will discuss this problem, as well as the nursing theory behind the proposal. Research for the proposal is based on the PICOT question: In adult surgical patients, will pre-warming the patient at least 15 minutes prior to induction of anesthesia, compared to only intraoperative warming, result in decreased incidence of perioperative hypothermia within the first two hours following surgery? Pre-operative warming of surgical patients for at least 30 minutes by means of forced air will be proposed to the nurse leaders, administration, and stakeholders at Tallahassee Memorial Hospital. The fifteen research articles sound in the CINAHL database show there are a multitude of factors that contribute to the occurrence of hypothermia as well as preventing it. This paper provides evidence the preoperative warming with a forced-air warmer, in addition to intraoperative warming on adult surgical patients helps in maintaining normothermia. Preoperative warming is safe, tolerated well, and increases patient satisfaction. Maintaining normothermia throughout all surgical phases will decrease healthcare costs to hospitals and patients. Implementing this proposal will not only prevent inadvertent hypothermia, but increase patient satisfaction, and lower costs to the hospital and patient.

This book is the first comprehensive, authoritative reference that provides a broad and comprehensive overview of Enhanced Recovery After Surgery (ERAS). Written by experts in the field, chapters analyze elements of care that are both generic and specific to various surgeries. It covers the patient journey through such a program, commencing with optimization of the patient’s condition, patient education, and conditioning of their expectations. Organized into nine parts, this book discusses metabolic responses to surgery, anaesthetic contributions, and optimal fluid management after surgery. Chapters are supplemented with examples of ERAS pathways and practical tips on post-operative pain control, feeding, mobilization, and criteria for discharge. Enhanced Recovery After Surgery: A Complete Guide to Optimizing Outcomes is an indispensable manual that thoroughly explores common post-operative barriers and challenges.