{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T04:26:01Z","timestamp":1773980761666,"version":"3.50.1"},"reference-count":25,"publisher":"AACN Publishing","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,10,1]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>In patients with acute neurological injury, abrupt temperature change exacerbates increased intracranial pressures and negatively affects perfusion pressure and cerebral blood flow. Critical care nurses must provide coordinated and effective interventions to maintain normothermia without precipitating shivering immediately after acute neurological injury in pediatric patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To improve hyperthermia management in a 40-bed pediatric intensive care unit, an interdisciplinary pediatric critical care team developed, implemented, and evaluated a targeted temperature management protocol.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The project was guided by the organization\u2019s plan-do-study-act quality improvement process. Quality improvement was assessed retrospectively using electronic medical records of patients meeting eligibility criteria. Samples of pediatric patients who received temperature interventions were compared before and after protocol implementation. The protocol included environmental, pharmacological, and body surface cooling device interventions, as well as use of a bedside shivering assessment scale and stepwise interventions to prevent and control shivering.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Before implementation of the targeted temperature management protocol, 64% of patients had documented temperatures higher than 37.5 \u00b0C, and body surface cooling devices were used in 10% of patients. After protocol implementation, more than 80% of patients had documented temperatures higher than 37.5 \u00b0C, and body surface cooling devices were used in 62% of patients. Four patients (6%) before and 5 patients (31%) after protocol implementation were treated with body surface cooling without requiring use of neuromuscular blockade.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Creation and implementation of a targeted temperature management protocol increased nurses\u2019 documented use of body surface cooling to manage hyperthermia in pediatric intensive care unit patients with acute neurological injury.<\/jats:p>\n               <\/jats:sec>","DOI":"10.4037\/ccn2021554","type":"journal-article","created":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T14:38:20Z","timestamp":1633099100000},"page":"41-50","source":"Crossref","is-referenced-by-count":2,"title":["Targeted Temperature Management Protocol in a Pediatric Intensive Care Unit: A Quality Improvement Project"],"prefix":"10.4037","volume":"41","author":[{"given":"Erica","family":"Prendergast","sequence":"first","affiliation":[{"name":"Erica Prendergast is a neurocritical care nurse practitioner, Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program, Ann & Robert H. Lurie Children\u2019s Hospital of Chicago, Chicago, Illinois."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiona Y.","family":"Allen","sequence":"additional","affiliation":[{"name":"Kiona Y. Allen is Medical Director of the Regenstein Cardiac Care Unit and Associate Director of the NICU-Cardiac Neurodevelopmental Program, Ann & Robert H. Lurie Children\u2019s Hospital of Chicago, and an assistant professor, Department of Pediatrics, Division of Cardiology and Division of Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele Grimason","family":"Mills","sequence":"additional","affiliation":[{"name":"Michele Grimason Mills is a neurocritical care nurse practitioner, Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program, Ann & Robert H. Lurie Children\u2019s Hospital of Chicago."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Moran","sequence":"additional","affiliation":[{"name":"Thomas Moran is Manager of Clinical Pharmacy Services, Ann & Robert H. Lurie Children\u2019s Hospital of Chicago."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Z. Leah","family":"Harris","sequence":"additional","affiliation":[{"name":"Z. Leah Harris is Chairman of Pediatrics at Dell Medical School, University of Texas at Austin, and Director of the Dell Pediatric Research Institute and Physician-in-Chief at Dell Children\u2019s Medical Center, Austin, Texas."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcelo","family":"Malakooti","sequence":"additional","affiliation":[{"name":"Marcelo Malakooti is Associate Chief Medical Officer and Medical Director of the pediatric intensive care unit, Ann & Robert H. Lurie Children\u2019s Hospital of Chicago, and an assistant professor, Department of Pediatrics, Division of Critical Care Medicine, Northwestern University Feinberg School of Medicine."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Craig M.","family":"Smith","sequence":"additional","affiliation":[{"name":"Craig Smith is an assistant professor of pediatrics and neurology, Northwestern University Feinberg School of Medicine, and faculty for pediatric critical care medicine and neurocritical care, Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program, Ann & Robert H. Lurie Children\u2019s Hospital of Chicago."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark S.","family":"Wainwright","sequence":"additional","affiliation":[{"name":"Mark S. 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