Clinical application of multidisciplinary team- and evidence-based practice project in gynecological patients with perioperative hypothermia

Table 5 Barriers and action strategies for prevention and management of hypothermia in patients

Serial number	Obstacle	Action strategy
1	Nurses lack relevant knowledge and awareness of perioperative hypothermia management of gynecological patients	To hold special training to explain relevant knowledge to nurses with PPT combined with nursing knowledge handbook, and to explain various procedures and nursing norms through on-site demonstration and watching operation videos. To ensure that nurses in the operating room, anesthesiology department and gynecology department receive knowledge training on hypothermia prevention at least once every six months, and to assess them for knowledge and practice at least once a year after training
2	The contents of health education on the day before surgery vary greatly and lacks gynecological expertise	To formulate a preoperative education manual of gynecology specialty, and to push the preoperative education video for gynecological patients by WeChat official account
3	The lithotomy position is mostly commonly used posture in gynecological surgery, resulting in inadequate ankle and foot warmth. In addition, there is a lack of special thermal insulation equipment for the lithotomy position	To purchase lithotomy position-dedicated strip-shaped inflatable heating blankets, wrap the patient’s legs with cotton pads, and use sterile leg covers to meet the warm-keeping requirements of patients undergoing surgery in the lithotomy position
4	There are communication barriers among multi-department nurses on the prevention and management of perioperative hypothermia in gynecological patients	To establish a perioperative hypothermia prevention and management group led by the head nurses who also play a key role in the practice reform, with operating room gynecological specialists, anesthesiology nurses, gynecological nurses as the team members and the head nurses of the three departments as the group leaders. To establish a WeChat exchange group to remind, supervise and control the quality in the preoperative ward, preoperative preparation room, intraoperative operating room and postoperative PACU. To listen to the feedback and suggestions of nurses and patients during field observation, and adjust and optimize the nursing process. The head nurse should report the practice changes to the evidence-based practice group every month, so as to discuss, analyze and solve the problems that arise
5	There is a lack of corresponding evaluation tools	To introduce the intraoperative hypothermia risk prediction model calculation software constructed by Professor Huang Yuguang to evaluate the hypothermia risk of patients, and to explain the checked contents. To self-develop a thermal comfort scale, and conduct unified training for medical staff

PACU: Postanesthesia care unit; PPT: Power point.