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Q Bulletin, Volume 1, No. 32 (Supplement 1), Jan - Dec 202412th National QA Convention, 8 %u2013 10 October 2024PP-32Reducing the Percentage of Admission Hypothermia in Preterm Infants in theNeonatal Unit Hospital MelakaLim SB1, Sharon L1, Wong LY1, Tan SJ11Paediatric Department Hospital Melaka, Melaka Tengah, MelakaSELECTION OF OPPORTUNITIES FOR IMPROVEMENT:Newborn hypothermia, particularly premature, is linked to significant morbidity and mortality.Verification study conducted in June 2022 in the neonatal unit of Hospital Melaka (HM) found analarming high rate (70.4%) of preterm newborns experiencing admission hypothermia (AH).KEY MEASURES FOR IMPROVEMENT:The key indicator is the percentage of incidence of AH in preterm newborns. The standard is %u226440% .PROCESS OF GATHERING INFORMATION:The study was conducted from June-December 2022 in HM's neonatal unit. Inclusion criteria are pretermnewborns from 25 to 36 weeks, six days gestation, and delivered in HM. Exclusion criteria are thoseadmitted after four hours of birth or having severe congenital malformation. Data was collected usinghypothermia checklists and self-administered questionnaires assessing medical personnel on hypothermia.Interventions were implemented in three phases from July - December 2022.ANALYSIS AND INTERPRETATION:In the verification study, the overall incidence of AH was 70.4% with 25.9% moderate AH. Only 20% ofstaff had scored %u226575% in the self-administered questionnaire with mean score knowledge 49.5%. Themain contributing factors were lack of staff knowledge of hypothermia (80%), non-standardised practiceamong staff (75%), and lack of or suboptimal thermal equipment (60%).STRATEGIES FOR CHANGE:Remedial phase one targets staff education with continuing medical education (CME). For remedial phasetwo, target establishment of standard operating procedure (SOP) via the introduction of protocol,hypothermia checklist, and new thermal equipment. For remedial phase three, focus on improving staffcompliance with educational videos and posters.EFFECT OF CHANGE:The overall AH rate was reduced to 41.2% following interventions, and moderate AH was reduced to9.1%. There was a narrowing of Achievable Benefits Not Achieved (ABNA) from 30.4% to 1.2%. 85%of staff scored %u226575% with the mean score of knowledge improved to 80%.THE NEXT STEP:The focus is ensuring compliance with thermal control SOP and regular audit cycles. Additional newtransport incubators and chemical thermal blankets would further reduce AH rate.85 | Page