Health Administration Services

2004-05 WSU Undergraduate Research Grant Application

Accuracy and Precision of Noninvasive and Core Temperatures during Surgery

Dollar Amount Requested from Undergraduate Research Funds: $3,000

Nielsen, Scott (Microbiology) Reinhart, Rachael (Microbiology)

Warner, Hillary (Nursing) Warner, Zachary (Zoology)

Student Names (last, first) and ID numbers

1-2 credit hours per person Spring 2006

Total Number of Credits Completed Anticipated Graduation (term/year) *

(* funds may NOT be spent after graduation)

Lloyd Burton, D.M., MHA, M.S. Ed and Dr. Douglas J. Reinhart, M.D., M.B.A

Faculty Mentor Name (last, first)

Health Administration Sciences, , Dr. Ezekiel R. Dumke College of Health Professions

Faculty Mentor Department, Mail Code, and College

This project X DOES _____ DOES NOT require review by the WSU Institutional Review Board for Human Subjects or the WSU Animal Care and Use Committee.

(Research project is currently under review by the McKay Dee Hospital IRB)

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Student Signature Date

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Project Mentor Signature Date

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Campus Mail Code Phone Extension

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Undergraduate Research Committee Representative Date

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Faculty Mentor Department Chair Date

Project Description:

During surgery, hypothermia occurs in most anesthetized patients. Hypothermia is a common cause of delayed awakening and increased length of stay in the post anesthetic care unit (PACU), (Sheng et al. 2003). Patient temperature is monitored in a variety of ways in an attempt to keep the patient body temperature controlled as much as possible (Kober et al. 2001). Typically, at McKay Dee Hospital, patients leave the operating room with normothermic or slightly hyperthermic core temperatures, but the tympanic temperature measurements obtained in recovery (PACU) are significantly lower. So, the accuracy of the thermometers needs to be evaluated because of the discrepancy between the OR and PACU temperatures. Although many proposals have been made, currently there is no standard of care for monitoring of body temperature during anesthesia as part of the American Society of Anesthesiologists Standards of Care (House of Delegates 2003). The goal of this research is to determine which mode of noninvasive temperature measurement is most accurate in comparison to invasive core temperature measurements.

The role of the primary researcher is to direct all aspects of the research project, ensure patient safety, and maintain objectivity in the study. The role of the student mentor is to advise research methodology with specific assistance in selecting and applying a test statistic to the data collected. The role of the students in this research is to perform background research, data collection in the operating room and PACU, assist in data analysis, authorship of abstract and complete full text, and project presentations. The students will be positioned behind the anesthesiologist and will collect temperature data from the monitoring devices on to a laptop computer spreadsheet. This project falls in the dependant category of the research continuum. Students have previous laboratory experience in chemistry, zoology, and microbiology data collection. All students have had clinical exposure at McKay Dee Hospital and have completed the NIH Human Participants Protection Education for Research Teams online training.

The results of this research project will determine the accuracy of noninvasive versus core temperature. Also, the results will assist PACU staff in determining the length of time a patient spends in recovery and minimize hospital expenditures using patient warming devices when they are not necessary. We will present the research to the American Society of Anesthesiologists Committee on Standards of Care. The results will be helpful in establishing a standard of care for monitoring body temperature during anesthesia. We will also present the research at the Weber State University Undergraduate Research Symposium.

The IRB of McKay Dee Hospital needs to approve the experiment to be conducted in the operating rooms and the timeline of experiment is dependant upon the length of time it takes to be approved (Currently under review). Once approved, research will begin. Informed consent will be obtained for patients participating in the experiment. After anesthesia is administered, temperature will be recorded in real time on a laptop computer every 15 minutes in 7 different locations: esophageal core temperature, indwelling bladder catheter core temperature, forehead skin (without insulation), forehead skin (with insulation), axillary, indwelling tympanic membrane probe (with insulation stopple), and handheld tympanic membrane temperature monitor. Data will be collected on 30 to 50 patients and this will take approximately 2 months from approval date. Using the bladder core temperature as the control, one-way ANOVA test will be applied to the data collected, to determine the variance of the other temperature measurements from the control. The project will be completed by April 29^th, 2005.

References:

Alexander Kober, Thomas Scheck, Bela Fulesdi, Frank Lieba, Wolfgangm Vlach,

Alexander Freidman, Daniel Sessler. 2001. Mayo Clin Proc. 76:369-375.

House of Delegates. 2003. Sandards for Basic Anesthetic Monitoring. www.asahq.org/publicationsandservices/standards/02.pdf#2.

Yiwei Sheng, Frank Zavisca, Elizebeth Schonlau, Renee Desmarattes, Edwin Herron, randall Cork. 2003. The Effects of Preoperative Reflective Hats and Jackets, and Interoperative Reflective Blankets on Perioperative Temperature. Volume 6: 1-9.

2004-05 WSU Undergraduate Research Budget Worksheet

BUDGET ITEM	Department or College Funds	Outside Agency Funds	Personal Funds	Undergrad. Research Funds	GRAND TOTAL
Materials		Waived*^(A)		$1,075.00*^(B)	$1,075.00
Equipment		Waived*^(A)			0
Travel to gather data			Paid for by researchers		0
Travel to present results (must have proof of acceptance)			To be decided later upon project completion		0
Stipend: Hrs @ $10/hr Benefits @ 8.5% Total				$1,925.00	$1,925.00
GRAND TOTAL	0	0	0	$3,000

NOTE – Equipment and left-over materials purchased with this grant will remain the property of WSU

* Detailed fund explanations.

(A) An administrative fee of $1600 is required to perform research at the hospital. However, the fee has been waived because the primary researcher is a practicing physician at McKay Dee Hospital and because the hospital will benefit from the research.

(B) Urinary catheters with a temperature probe:

The cost for a catheter with a temperature probe is $18 more that the cost of a simple catheter. The research team is to pay for the $18 increase for the 50 patients. The total amount for the catheters is $900.

Forehead skin temperature probe:

Two forehead skin temperature probes will be used for data collection. One is a standard procedure for the hospital and does not need to be paid for. The other will be paid for by the research team at a cost of $1.50. For 50 patients the total cost will be $75. The insulation tape used is included in the estimated cost.

Indwelling tympanic membrane probe:

The probe will cost $2.00 a piece. For 50 patients the total cost will be $100.

Tympanic membrane probe:

The cost for the use of the hospital’s thermometer will be waived. No funds needed.

2004-05 WSU Undergraduate Research Faculty Mentor Recommendation Form

Student Name (last, first): Nielsen, Scott; Reinhart, Rachael; Warner, Hillary; Warner, Zachary

Project Title: Accuracy and Precision of Noninvasive and Core Temperatures during Surgery

Mentor Directions: After carefully reviewing the proposal and assessing both the viability of this project and the qualifications of the student requesting funding, answer the questions found below. If the project involves the use of human subjects or protected animals, be sure the student secures IRB or ACUC approval. If the project receives funding, it is your responsibility to work closely with the student, monitor the ongoing progress of the project and budget, and evaluate the project’s results. Failure to do so will jeopardize funding for this project and any future projects.

1. How long and in what capacity have you known this student?

We met for the first time October 10^th, 2004 to discuss the methodology of this study and possible statistical treatments of the data the students plan to collect. Since I teach biostatistics and Epidemiology (HIM 3200), I was asked by Dr. Doug Reinhart to meet with him and the students to assist them in development of a research model.

2. Briefly describe the proposed project. Is this part of a larger research project?

The project will measure body temperature of surgery patients in the operating room and recovery to determine if there is a significant difference in seven body locations for taking temperature. This is not part of a larger research project.

3. Give an assessment of the project’s significance to the student’s discipline and of the project’s educational and/or professional benefit to the student.

This is an excellent project for pre-med and nursing students. It will give them practical exposure to the management of patients undergoing surgery and an opportunity to research the significance of measuring the vital sign of temperature in surgery and during recovery.

4. Comment on the qualifications of the student to successfully complete this project, both in terms of the project’s scope and its time frame.

Because of the assistance of Dr. Reinhart and myself, the students will be able to collect temperature data form 30-50 patients undergoing surgery at McKay Dee Hospital. All of the students are either pre-med or nursing students. This will enhance their knowledge and experience as they pursue medical education and a health professions career.

5. Comment on the justification and appropriateness of the project budget.

The cost for the equipment is adequate and even far less than it would be if we were doing it independently. Concerning the stipend, the funds are appropriate because the students are involved in the background research, planning and development of research protocol, obtaining informed consent, temperature data collection both intra-operative and post-operative, data analysis, composition of the abstract and full text of the research, and presentation of research findings.

6. Describe your role in the project.

My role will be that of research methodology advisor with specific assistance in selecting and applying a test statistic to the data collected.

7. Include anything else that you think will be helpful to the committee in evaluating this application.

Dr. Doug Reinhart is a Board Certified Anesthesiologist with clinical privileges at McKay Dee Hospital. He is also a non-traditional student enrolled in my statistics course this semester. He has a personal interest in this research because it may provide information that could be used by physicians and nurses to better manage patients in a post anesthesia condition. There is potential that this research could have an positive impact on patient care and costs of care.

This project X DOES ____ DOES NOT require review by the WSU Institutional Review Board for Human Subjects or the WSU Animal Care and Use Committee.

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Project Mentor Signature Date

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Campus Mail Code Phone Extension

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