Christine Evans and her husband, Jason, grew their family by two on Nov. 18 at Fort Worth’s Texas Health Harris Methodist Hospital. Immediately afterward, Christine, 37, watched as premature daughters Emma and Abigail—born at 3 pounds and 2 pounds 11 ounces, respectively—were placed inside plastic see-through “ponchos,” tucked into incubation units, and then wheeled away to the hospital’s neonatal intensive care unit, where they were cleared to go home in January.
Texas Health Fort Worth’s NICU center provides families with advanced care for premature or special-medical-needs babies. The 63-bed center admits about 625 patients per year, with one-third of them in the “low birth weight” category: that is, they weigh under 1,500 grams (or about 3 pounds) at birth, and arrive at less than 32 weeks of gestational age.
These conditions make the babies especially susceptible to “temperature instability,” or heat loss. Heat loss makes them more prone to infection, interventricular hemorrhaging, brain bleeding, and long-term oxygen dependency. So, the Texas Health Fort Worth NICU program created an innovative, forward-thinking strategy to provide specialized care to these babies.
Four years ago, it began reviewing data to improve patient outcomes–specifically with regard to the babies’ admission temperatures. Over two years, Lindsey Canon, the hospital’s NICU manager, and Stephanie Eidson, a clinical educator, worked with an interdisciplinary team on something called the “Hypothermia Eradication from Admission Temperatures” study.
Explains Eidson: “The main focus of HEAT was to increase the delivery-room temperature to create an optimal environment when the baby arrives. We started HEAT research with 26-week triplets and collected data on 430 babies.”
The team’s findings allowed it to devise its most successful combination of tools yet to stabilize patients’ internal temperature. Among them: setting the thermostat in the delivery room to a “hot-as-Hades” temperature of 76 degrees Fahrenheit; using preheated, radiant warmers in the incubators; and encasing each baby in a makeshift, one-gallon, Ziploc freezer bag poncho. A hole is cut in the top of the bag and the baby is slipped in head-first.
The hospital has proved these methods work. Says Canon: “Since our findings, the percentage of hypothermic infants on NICU admission decreased from 20 to 10 percent, and the percentage of infants with normal temperatures increased from 50 to 70 percent.”
By stabilizing the delivery-room temperature—and discovering that Ziploc brand bags work best due to their “durability and strength”—Texas Health Fort Worth gained recognition for its NICU work, recently winning an American Excess Insurance Exchange grant of $12,000 to further educate the staff. “I’ve been with Texas Health Fort Worth for 35 years, and feel my calling has always been with NICU,” Eidson says. “We’re a special unit, and it takes a village to do what we do.” It’s a hot unit, for sure.