Skip to main content

The AHRQ National Quality Measures Clearinghouse (NQMC, qualitymeasures.ahrq.gov) Web site will not be available after July 16, 2018 because federal funding
through AHRQ will no longer be available to support the NQMC as of that date. For additional information, read our full announcement.
  • Measure Summary
  • NQMC:010647
  • Jan 2015

Perinatal care: proportion of infants with temperature measured within one hour of admission to the NICU.

Vermont Oxford Network. First temperature measured within one hour of admission to the neonatal intensive care unit (NICU) and first temperature less than 36 degrees C. Burlington (VT): Vermont Oxford Network; 2015. 4 p.

This is the current release of the measure.

Primary Measure Domain

Clinical Quality Measures: Process

Secondary Measure Domain

Does not apply to this measure

Description

This measure is used to assess the proportion of infants with temperature measured within one hour of admission to the neonatal intensive care unit (NICU).

Rationale

Body temperature drops quickly after birth in premature newborns, due to high surface area to mass ratio and lack of efficient thermoregulation responses. Cold stress in these infants can lead to increased oxygen demand, respiratory compromise, and hypoglycemia. As a result, hypothermia is associated with increased rates of major morbidity and mortality (Bissinger & Annibale, 2010). Extensive research demonstrates an association between temperatures less than 36°C (moderate or severe hypothermia) with adverse outcomes, (Laptook et al., 2007) with lowest rates of adverse outcomes in infants with body temperatures greater than or equal to 36.5°C (Lyu et al., 2015). Manipulation of environmental temperature (including room temperature and humidity, and prewarming surfaces in contact with infants), polyethylene wraps (less than 28 weeks), exothermic mattresses, and skin-to-skin contact have been shown to significantly reduce hypothermia for infants less than 36 weeks (Bissinger & Annibale, 2010; Bobby et al., 2014; DeMauro et al., 2013; McCall et al., 2008; Russo et al., 2014; World Health Organization, 1997). The World Health Organization (1997) recommends that newborn body temperature be maintained between 36.5-37.5°C, and suggests that mild hypothermia (36-36.4°C) can be treated with skin-to-skin contact in a warm room, while moderate (32-35.9°C) and severe (less than 32°C) hypothermia require further interventions.

Monitoring temperature is an important first step in thermal regulation. All infants admitted to a neonatal intensive care unit (NICU) should have a temperature measured in the first hour of admission. The percentage of infants whose temperature is measured and recorded is a measure of the quality of care. The percentage of infants with core temperature less than 36°C is another important quality measure (see the National Quality Measures Clearinghouse [NQMC] summary Perinatal care: proportion of infants with temperature less than 36 degrees Celsius among those with temperature measured within one hour of admission to the NICU).

Evidence for Rationale

Bissinger RL, Annibale DJ. Thermoregulation in very low-birth-weight infants during the golden hour: results and implications. Adv Neonatal Care. 2010 Oct;10(5):230-8. PubMed External Web Site Policy

Bobby PD, Cabral J, Cianella J, Matias S, Kelley E, Bowman D. Reducing the incidence of hypothermia in preterm neonates: a community hospital experience. Obstet Gynecol. 2014;123:139S.

DeMauro SB, Douglas E, Karp K, Schmidt B, Patel J, Kronberger A, Scarboro R, Posencheg M. Improving delivery room management for very preterm infants. Pediatrics. 2013 Oct;132(4):e1018-25. PubMed External Web Site Policy

Laptook AR, Salhab W, Bhaskar B, Neonatal Research Network. Admission temperature of low birth weight infants: predictors and associated morbidities. Pediatrics. 2007 Mar;119(3):e643-9. PubMed External Web Site Policy

Lyu Y, Shah PS, Ye XY, Warre R, Piedboeuf B, Deshpandey A, Dunn M, Lee SK, Canadian Neonatal Network. Association between admission temperature and mortality and major morbidity in preterm infants born at fewer than 33 weeks' gestation. JAMA Pediatr. 2015 Apr;169(4):e150277. PubMed External Web Site Policy

McCall EM, Alderdice FA, Halliday HL, Jenkins JG, Vohra S. Interventions to prevent hypothermia at birth in preterm and/or low birthweight infants. Cochrane Database Syst Rev. 2008;(1):CD004210.

Russo A, McCready M, Torres L, Theuriere C, Venturini S, Spaight M, Hemway RJ, Handrinos S, Perlmutter D, Huynh T, Grunebaum A, Perlman J. Reducing hypothermia in preterm infants following delivery. Pediatrics. 2014 Apr;133(4):e1055-62. PubMed External Web Site Policy

Vermont Oxford Network. First temperature measured within one hour of admission to the neonatal intensive care unit (NICU) and first temperature less than 36 degrees C. Burlington (VT): Vermont Oxford Network; 2015. 4 p.

World Health Organization (WHO). Thermal protection of the newborn: a practical guide. Geneva: World Health Organization (WHO); 1997.

Primary Health Components

Perinatal care; body temperature measurement; neonatal intensive care unit (NICU); infants

Denominator Description

All eligible infants admitted to a neonatal intensive care unit (NICU) in the hospital for whom it is known whether the body temperature was measured within one hour of admission to the NICU (see the related "Denominator Inclusions/Exclusions" field)

Numerator Description

Total number of eligible infants whose body temperature was measured within one hour of neonatal intensive care unit (NICU) admission (see the related "Numerator Inclusions/Exclusions" field)

Type of Evidence Supporting the Criterion of Quality for the Measure

  • A systematic review of the clinical research literature (e.g., Cochrane Review)
  • One or more research studies published in a National Library of Medicine (NLM) indexed, peer-reviewed journal

Additional Information Supporting Need for the Measure

Unspecified

Extent of Measure Testing

Unspecified

State of Use

Current routine use

Current Use

Collaborative inter-organizational quality improvement

Internal quality improvement

Quality of care research

Measurement Setting

Hospital Inpatient

Intensive Care Units

Professionals Involved in Delivery of Health Services

Advanced Practice Nurses

Nurses

Physician Assistants

Physicians

Least Aggregated Level of Services Delivery Addressed

Single Health Care Delivery or Public Health Organizations

Statement of Acceptable Minimum Sample Size

Unspecified

Target Population Age

Less than or equal to 28 days after birth

Target Population Gender

Either male or female

National Quality Strategy Aim

Better Care

National Quality Strategy Priority

Health and Well-being of Communities
Prevention and Treatment of Leading Causes of Mortality

IOM Care Need

Staying Healthy

IOM Domain

Effectiveness

Timeliness

Case Finding Period

Calendar year (January 1 through December 31)

Denominator Sampling Frame

Patients associated with provider

Denominator (Index) Event or Characteristic

Institutionalization

Patient/Individual (Consumer) Characteristic

Denominator Time Window

Time window precedes index event

Denominator Inclusions/Exclusions

Inclusions
All eligible infants admitted to a neonatal intensive care unit (NICU) in the hospital for whom it is known whether the body temperature was measured within one hour of admission to the NICU

Population: Any infant who is admitted to a NICU within 28 days of birth should be included.

Note: Refer to the original measure documentation for calculation instructions and data item definitions. For administrative coding and additional data item information, refer to the 2016 Manual of Operations: Part 2 Data Definitions & Infant Data Forms (see the "Companion Documents" field).

Exclusions

  • Infants admitted more than 28 days after birth
  • Infants who have been home prior to admission
  • Infants not admitted to the NICU

Exclusions/Exceptions

Unspecified

Numerator Inclusions/Exclusions

Inclusions
Total number of eligible infants whose body temperature was measured within one hour of neonatal intensive care unit (NICU) admission

Note: Refer to the original measure documentation for additional information.

Exclusions
Unspecified

Numerator Search Strategy

Institutionalization

Data Source

Administrative clinical data

Electronic health/medical record

Paper medical record

Type of Health State

Does not apply to this measure

Instruments Used and/or Associated with the Measure

Unspecified

Measure Specifies Disaggregation

Does not apply to this measure

Scoring

Rate/Proportion

Interpretation of Score

Desired value is a higher score

Allowance for Patient or Population Factors

Analysis by subgroup (stratification by individual factors, geographic factors, etc.)

Description of Allowance for Patient or Population Factors

Gestational age, birth weight, inborn/outborn status

Standard of Comparison

External comparison of time trends

Internal time comparison

Original Title

First temperature measured within one hour of admission to the neonatal intensive care unit (NICU).

Measure Collection Name

Perinatal Care Measures

Submitter

Vermont Oxford Network - Health Care Quality Collaboration

Developer

Vermont Oxford Network - Health Care Quality Collaboration

Funding Source(s)

None

Composition of the Group that Developed the Measure

Neonatologists

Financial Disclosures/Other Potential Conflicts of Interest

None

Adaptation

This measure was not adapted from another source.

Date of Most Current Version in NQMC

2015 Jan

Measure Maintenance

Unspecified

Date of Next Anticipated Revision

Unspecified

Measure Status

This is the current release of the measure.

Source(s)

Vermont Oxford Network. First temperature measured within one hour of admission to the neonatal intensive care unit (NICU) and first temperature less than 36 degrees C. Burlington (VT): Vermont Oxford Network; 2015. 4 p.

Measure Availability

Source not available electronically.

For more information, contact the Vermont Oxford Network, 33 Kilburn Street, Burlington, Vermont, 05401; Phone: 802-865-4814; Fax: 802-865-9613; Email: mail@vtoxford.org; Web site: https://public.vtoxford.org/ External Web Site Policy.

Companion Documents

The following is available:

  • Vermont Oxford Network. 2016 manual of operations: part 2 data definitions & infant data forms. Release 20.0. Burlington (VT): Vermont Oxford Network; 2015 Oct. 93 p. This document is available from the Vermont Oxford Network Web site External Web Site Policy.

NQMC Status

This NQMC summary was completed by ECRI Institute on February 2, 2016. The information was verified by the measure developer on March 16, 2016.

Copyright Statement

No copyright restrictions apply.

NQMC Disclaimer

The National Quality Measures Clearinghouse™ (NQMC) does not develop, produce, approve, or endorse the measures represented on this site.

All measures summarized by NQMC and hosted on our site are produced under the auspices of medical specialty societies, relevant professional associations, public and private organizations, other government agencies, health care organizations or plans, individuals, and similar entities.

Measures represented on the NQMC Web site are submitted by measure developers, and are screened solely to determine that they meet the NQMC Inclusion Criteria.

NQMC, AHRQ, and its contractor ECRI Institute make no warranties concerning the content or its reliability and/or validity of the quality measures and related materials represented on this site. Moreover, the views and opinions of developers or authors of measures represented on this site do not necessarily state or reflect those of NQMC, AHRQ, or its contractor, ECRI Institute, and inclusion or hosting of measures in NQMC may not be used for advertising or commercial endorsement purposes.

Readers with questions regarding measure content are directed to contact the measure developer.

About NQMC Measure Summaries

NQMC provides structured summaries containing information about measures and their development.

Measure Summary FAQs


Measure Summaries

New This Week

View more and sign up for our Newsletter

Get Adobe Reader