Triage nurse's assessment of a child with a fever.

Fever in children is a common presentation to the emergency department and in most instances has no adverse consequences. The role of the triage nurse is to have thorough knowledge of up to date practices in caring for the child with fever, and to accurately assess and manage the child. Using evidence based practice to apply appropriate triage categories, effective care including accurate and informed education of parents. Every nurse working on triage should maintain current knowledge and have continuous education concerning the child with fever and the unwell child to promote best patient outcomes and maintain best practice standards.

Assessment of body temperature measurement options.

Assessment of body temperature is important for decisions in nursing care, medical diagnosis, treatment and the need of laboratory tests. The definition of normal body temperature as 37°C was established in the middle of the 19th century. Since then the technical design and the accuracy of thermometers has been much improved. Knowledge of physical influence on the individual body temperature, such as thermoregulation and hormones, are still not taken into consideration in body temperature assessment. It is time for a change; the unadjusted mode should be used, without adjusting to another site and the same site of measurement should be used as far as possible. Peripheral sites, such as the axillary and the forehead site, are not recommended as an assessment of core body temperature in adults. Frail elderly individuals might have a low normal body temperature and therefore be at risk of being assessed as non-febrile. As the ear site is close to the hypothalamus and quickly responds to changes in the set point temperature, it is a preferable and recommendable site for measurement of body temperature.

What is the evidence base for the assessment and evaluation of body temperature?

Measurement and management of body temperature is often based on traditionand personal ideas and beliefs rather than evidence based knowledge. This article summarises the literature to provide a guide to evidence based assessment and evaluation of body temperature in clinical practice.

Paediatric fever management: continuing education for clinical nurses.

PURPOSE: This study examined the influence of level of practice, additional paediatric education and length of paediatric and current experience on nurses' knowledge of and beliefs about fever and fever management. METHOD: Fifty-one nurses from medical wards in an Australian metropolitan paediatric hospital completed a self-report descriptive survey. RESULTS: Knowledge of fever management was mediocre (Mean 12.4, SD 2.18 on 20 items). Nurses practicing at a higher level and those with between one and four years paediatric or current experience were more knowledgeable than novices or more experienced nurses. Negative beliefs that would impact nursing practice were identified. Interestingly, beliefs about fever, antipyretic use in fever management and febrile seizures were similar; they were not influenced by nurses' knowledge, experience, education or level of practice. CONCLUSIONS: Paediatric nurses are not expert fever managers. Knowledge deficits and negative attitudes influence their practice irrespective of additional paediatric education, paediatric or current experience or level of practice. Continuing education is therefore needed for all paediatric nurses to ensure the latest clear evidence available in the literature for best practice in fever management is applied.

Primary reasons for ED visits and procedures performed for patients who saw nurse practitioners.

INTRODUCTION: Little is known, from a national perspective, about what types of patients are seen by nurse practitioners in the emergency department. METHODS: Data from 1545 participating emergency departments across the United States during 1997, 1998, 1999, and 2000 were collected from nationally representative samples of urban and rural hospitals using the National Hospital Ambulatory Medical Care Surveys. Results Nurse practitioners saw 5.76 million ED patients during the 4-year period. Using the Reason for Visit Classification developed by the National Center for Health Statistics, the primary category for patients seen by nurse practitioners was classified as "Injury by type and/or location." The types of injuries in this category were lacerations and cuts to an upper extremity and facial area; injuries to the head, neck, and face; and foreign bodies in the eye. The next most common category was classified under "General symptoms." Nurse practitioners saw patients in this category with symptoms of chest pain, side or flank pain, fever, and edema. DISCUSSION: The findings from this study provide insight into the types of patient visits seen by nurse practitioners in emergency departments in the United States and the services and procedures that were received by patients.

Clinical benefits of 3M Tempa.DOT thermometer in paediatric settings.

Single-use clinical thermometers provide a safe alternative to the traditional mercury in glass thermometers for routine temperature taking. This article examines the 3M Tempa.DOT Single-Use Clinical Thermometer and discusses its use in the paediatric setting.

Palliative fever management in Alzheimer patients. quality plus fiscal responsibility.

Aggressive medical treatment of infections does not affect the progressive course of dementia of the Alzheimer type (DAT) and has limited effect on the mortality rate. Utilization of health care resources and discomfort during a fever episode were compared in three differing treatment conditions: in 18 patients in a dementia special care unit (DSCU) who received palliative management, 26 patients in a DSCU who were treated aggressively, and 17 DAT patients in traditional long-term care units who were treated aggressively. Both groups of patients in the DSCU had lower discomfort scores, lower utilization of high-cost health care resources, and higher utilization of analgesics and narcotics. A nursing model of care incorporating hospice concepts into the DSCU is suggested.