Study: Knowledge gaps hinder perioperative hypothermia prevention

Editor's Note

Surgical staff support for OR temperature management is not always paired with the knowledge required to properly prevent perioperative hypothermia, according to an April 30 study in Nature: Scientific Reports.

This multicenter, cross-sectional study surveyed 213 operating room professionals—surgeons, anesthesiologists, and nurses—across eight hospitals in northern China. The goal was to assess their knowledge, attitudes, and practices (KAP) regarding the prevention of unintentional perioperative hypothermia, a common and clinically significant risk for surgical patients. The researchers developed and validated a 44-item questionnaire based on Chinese and international guidelines.

The researchers found that while respondents overwhelmingly recognized the clinical importance of preventing hypothermia and reported broadly favorable attitudes, knowledge scores were comparatively low. Attitudes were uniformly positive across roles and education levels, with nearly all respondents agreeing that nurses, anesthesiologists, and surgeons share responsibility for heat preservation in the operating room. However, only 13.6% correctly identified ambient temperature recommendations for surgery, and just 16.4% were aware that warming devices should be used before anesthesia induction in procedures exceeding 30 minutes. These findings suggest gaps not only in baseline knowledge but also in familiarity with specific evidence-based protocols.

Despite modest knowledge levels, statistical modeling revealed a significant relationship between what providers know and how they act. Structural equation modeling showed that knowledge had a strong direct effect on attitude and an indirect effect on practice. Attitude, in turn, emerged as a strong predictor of behavior, reinforcing the importance of staff buy-in for effective temperature management. Subgroup analysis further revealed that nurses using warming technologies such as air blowers and infusion warmers tended to have more positive attitudes and better adherence to best practices, while nurses with 11–15 years of experience were more likely to exhibit knowledge deficits.

Results varied by profession. For example, Surgeons scored highest on knowledge, followed by nurses and anesthesiologists. Practice scores varied significantly by education level and occupation, with higher scores among those whose hospitals had hypothermia prevention protocols.

“Although the small regional sample limits generalizability, these findings highlight the need for targeted training programs and standardized protocols to improve adherence to perioperative hypothermia prevention guidelines in similar healthcare settings,” researchers conclude.