Table 1 Bundle of Temperature management procedure at NICUs

Prenatal preparation

 1. Prenatal preparation (prenatal consultation, form multidisciplinary team, check materials)

 2.Set the ambient temperature above 25 °C, set radiant warmers at 34℃

 3.Prewarm the hat

 4.Prepare a polyethylene wrap

 5. Push a heated transport incubator forward to delivery or operating room, plug it in and keep charging, switch on incubator and set it to target temperature range:36–36.5 °C

Resuscitation euthermia

 6.Preheated blankets wrapping after birth

 7.Quickly weight after being placed in a pre-warmed blanket

 8.Infant immediately after birth wrapped with a polyethylene wrap without drying

 9.Place a pre-warmed hat on the head

 10.Resuscitation under chemical preheated mattress

 11.Document temperature at 10 min after birth

Transportation euthermia

 12. Put infants into a heated transport incubator and start transportation

After admission to NICU

 13.Preheat daily materials in incubator (diapers, oxygen probe, stethoscope)

 14.Put the infants into the incubator immediately when arriving at NICU

 15. Document temperature continuously within one hour after birth

 16. Retest temperature when arriving at the NICU, soon after every 30 min

 17. Document the time point when temperature at ≥ 36.5℃

 18.Nuring and medical operations are centralized implemented

 19.Training and assessments on temperature measurement for nurses, making temperature measurement standard

 20. Monthly charts reporting on hypothermia distribution and data quality, doing Plan–Do–Study–Act circles continuously