# A Quality Improvement Initiative to Improve Normothermia While Transitioning Premature Infants to an Open Crib

## TL;DR

This study shows how a quality improvement program successfully reduced failed attempts when moving premature infants to open cribs.

## Contribution

The study introduces a standardized protocol and checklist to improve normothermia during open crib transitions for preterm infants.

## Key findings

- Failed crib transitions decreased by 76% over 18 months.
- Infants born between 32 and 35 weeks had higher failure rates.
- Standardized protocols and checklists improved transition success rates.

## Abstract

Current literature focuses on the optimal lowest weight and incubator temperature to transition an infant to an open crib, with minimal data quantifying the rate of failed attempts or standardizing the process. Due to multiple failed attempts at this institution in 2021, the project aimed to reduce the rate of preterm newborns who failed the crib by 10% in 1 year.

Interventions, including nursing education, an audit checklist, environmental changes, and a standardized protocol, were implemented after establishing baseline data.

The incidence of failed transitions to an open crib decreased from a baseline of 13.5% failed cribs per monthly transition attempts to 3.3% failed cribs per monthly transition attempts in 18 months, a 76% decrease, where it is currently sustained. Of note, infants born between 32 and 35 weeks gestation had higher failure rates compared with those born <32 weeks.

Compliance with a thermoregulation protocol, utilizing an audit checklist, and standardizing the process improved the success rate of transitioning to an open crib.