Date of Doctor of Nursing Practice Project Completion
Spring 5-4-2026
Faculty Advisor
Dr. Francine Snow
Abstract
Reducing Intraoperative Hypothermia in Adults 18-60 Undergoing Primary Elective Unilateral Total Knee Replacement with General Anesthesia
Background
Intraoperative hypothermia (core temperature < 36°C) is associated with increased surgical site infections, blood loss, prolonged recovery, and longer hospital stays. Because forced-air warming devices are restricted during total joint arthroplasty at the project site due to infection concerns, patients relied on passive warming, resulting in a baseline hypothermia rate of 63.3%
Purpose
The purpose of this quality improvement project was to reduce the incidence of intraoperative hypothermia among adults aged 18-60 undergoing primary elective unilateral total knee arthroplasty with general anesthesia by implementing a conductive warming device in the operating room of a large level 1 trauma hospital
Methodology
This evidence-based quality improvement project implemented a conductive warming blanket following staff education. Data was collected through the electronic health record. Primary outcomes included hypothermia incidence and average intraoperative temperature. Secondary outcomes included staff compliance and device-related adverse events.
Results
Hypothermia incidence decreased from 63.3% to 30%, exceeding the project goal. Average intraoperative temperatures increased by 0.5-0.8 °F, no device-related injuries occurred, and staff compliance reached 67%, improving after reinforcement
Implications
Conductive warming effectively reduced intraoperative hypothermia while providing a safe alternative when forced-air warming was restricted. Although the project was limited by a small sample size, lower-than-expected staff compliance, and limited device availability during implementation, meaningful improvements in patient temperature were observed. The intervention has been adopted as the standard warming practice for total joint surgeries and expanded to other surgical specialties, supporting sustainability. Future initiatives should increase sample size, improve staff compliance, and evaluate long-term patient outcomes.
Keywords
Intraoperative hypothermia, conductive warming, total knee arthroplasty, quality improvement, perioperative nursing
Recommended Citation
Carrigan Collinsworth, "Reducing Intraoperative Hypothermia in Adults 18-60 Undergoing Primary Elective Unilateral Total Knee Replacement with General Anesthesia" (2026). Doctor of Nursing Practice Final Project Abstract. 198.
https://digitalcommons.library.tmc.edu/dnp_abstract/198