Quality Metrics for a Therapeutic Hypothermia Program

In honor of HIE Awareness Month, we’re continuing to focus on neonatal hypoxic brain injury topics.  This week, we’re highlighting the work of one of our Brain Cooling Club faculty members, Carolyn Lund, RN, MS, FAAN.  In her lecture on quality metrics for therapeutic hypothermia, Carolyn takes us through the metrics they are tracking in the UCSF Benioff Children’s Hospital Oakland NICU. 

Outside of goal temp on admission:

Do you cool on transport? Are you hitting your target temperatures on admission? Tracking this metric helps to evaluate the effectiveness of your transport cooling program.

Seizures:

Are you using brain monitoring for your Therapeutic Hypothermia patients? Do you use aEEG, vEEG or both? Are you tracking the number of patients who have seizure activity during Therapeutic Hypothermia and/or rewarming?

Hours to re-warm:

How long is it taking to rewarm patients when therapeutic hypothermia is complete? Are you in a 6 to 8 hour window?

Carolyn Lund has been a Neonatal Clinical Specialist in the NICU for over 30 years and is also the ECMO coordinator at UCSF Benioff Children’s Hospital Oakland. She is an Associate Clinical Professor in the school of nursing at the University of California San Francisco. Although best known for research and writing about neonatal skincare, she has been involved in therapeutic hypothermia since 1999, when the Oakland NICU participated in the “Cool Cap” trial.

She has attended the Bay Area “Cooling Summit” meetings (now known as the Neonatal Neurology Summit) since 2015. This is a multidisciplinary group consisting of neonatologists, neurologists, nurses and nurse practitioners from neonatal therapeutic hypothermia programs in Northern California. She has given presentations to this group on skin issues and quality metrics related to therapeutic hypothermia programs.