Korean Journal of Adult Nursing (성인간호학회지)

Korean Society of Adult Nursing (한국성인간호학회)
권호 표지
DOI QR코드

DOI QR Code

Development and Evaluation of an Evidence-Based Nursing Protocol for Fever Management in Adult Patients

성인 발열 환자를 위한 근거기반 간호 지침 개발 및 평가

  • Received : 2013.01.02
  • Accepted : 2013.06.17
  • Published : 2013.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: This study was designed to develop, to implement and evaluate a fever management nursing protocol for adult patients. Methods: This study was conducted through seven steps following both the guideline development procedures of the Scottish Intercollegiate Guidelines Network and the Model of the Asan Medical Center Evidence-Based Practice, as follows: 1) identifying the clinical needs and composition of the protocol development group; 2) identifying and evaluating the evidence; 3) assessing the level of evidence and grading recommendations; 4) forming a protocol; 5) evaluating the protocol using an expert group validity test and identifying barriers to its implementation; 6) protocol development; and 7) evaluation of practical improvement measures following implementation of the protocol. Results: The evidence-based protocol for fever management in adult patients was completed and includes five domains and 15 items. The protocol had good content validity (CVI=.90) and nursing practice could be improved after implementation of the protocol. Conclusion: This nursing protocol can be used as a guide for nursing in febrile adult patients. We recommend that further guidelines be updated in an interdisciplinary manner in order to foster local adaptation of the best clinical practices.

Keywords

References

  1. Asan Medical Center. (2010). AMC model of evidence-based practice. Seoul: Asan Medical Center, Department of Nursing.
  2. Adams, H. P. J., del Zoppo, G., Alberts, M. J., Bhatt, D. L., Brass, L., Furlan, A., et al. (2007). Guidelines for the early management of adults with ischemic stroke: A guideline from the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: The American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists. Stroke, 38 (5), 1655-1711. http://dx.doi.org/10.1161/STROKEAHA.107.181486
  3. American Medical Directors Association. (2009). Dehydration and fluid maintenance in the long-term care setting (NGC-7636). Retrieved September 14, 2010, from http://www.guidelines.gov/content.aspx?id=15590&search=dehydration+and+fluid+maintenance
  4. Badjatia, N., Strongilis, E., Prescutti, M., Fernandez, L., Fernandez, A., Buitrago, M., et al. (2009). Metabolic benefits of surface counter warming during therapeutic temperature modulation. Critical Care Medicine, 37 (6), 1893-1897. http://dx.doi.org/10.1097/CCM.0b013e31819fffd3
  5. Broessner, G., Beer, R., Lackner, P., Helbok, R., Fischer, M., Pfausler, B., et al. (2009). Prophylactic, endovascularly based, long-term normothermia in ICU patients with severe cerebrovascular disease: Bicenter prospective, randomized trial. Stroke, 40 (12), e657-665. http://dx.doi.org/10.1161/STROKEAHA.109.557652
  6. Celik, S., Yldrm, I., Arslan, I., Yldrm, S., Erda, l. F., & Yand, Y. (2011). Hemodynamic and oxygenation changes in surgical intensive care unit patients with fever and fever lowering nursing interventions. International Journal of Nursing Practice, 17 (6), 556-561. http://dx.doi.org/10.1111/j.1440-172X.2011.01973.x
  7. Edwards, H., Walsh, A., Courtney, M., Monaghan, S., Wilson, J., & Young, J. (2007). Improving paediatric nurses' knowledge and attitudes in childhood fever management. Journal of Advanced Nursing, 57 (3), 257-269. http://dx.doi.org/10.1111/j.1365-2648.2006.040 77.x
  8. Fauci, A., Braunwald, E., Kasper, D., Hauser, S., Longo, D., Jameson, J., et al. (2008). Harrison's Principle of Internal Medicine (17 ed.). New York: The McGraw-Hill Companies.
  9. Gozzoli, V., Treggiari, M. M., Kleger, G. R., Roux-Lombard, P., Fathi, M., Pichard, C., et al. (2004). Randomized trial of the effect of antipyresis by metamizol, propacetamol or external cooling on metabolism, hemodynamics and inflammatory response. Intensive Care Medicine, 30 (3), 401-407. http://dx.doi.org/10.1007/s00134-003-2087-2
  10. Grossman, D., Keen, M. F., Singer, M., & Asher, M. (1995). Current nursing practices in fever management. Academy of Medical-Surgical Nurses, 4 (3), 193-198.
  11. Hammond, N., & Boyle, M. (2011). Pharmacological versus nonpharmacological antipyretic treatments in febrile critically ill adult patients: A systematic review and meta-analysis. Australian Critical Care, 24 (1), 4-17. http://dx.doi.org/10.1016/j.aucc.2010.11.002
  12. High, K. P., Bradley, S. F., Gravenstein, S., Mehr, D. R., Quagliarello, V. J., Richards, C., et al. (2009). Clinical practice guideline for the evaluation of fever and infection in older adult residents of long-term care facilities: 2008 Update by the Infectious Diseases Society of America. Journal of American Geriatrics Society, 57 (3), 375-394. http://dx.doi.org/10.1111/j.1532-5415.2009.02175.x
  13. Joanna Briggs Institute. (1999). Best practice: Evidence based practice information sheets for health professionals. Best Practice Information Sheets, 3 (3), 1-6. Retrieved 1999, from http://connect.jbiconnectplus.org/ViewSourceFile.aspx?0=4309
  14. Johnston, N. J., King, A. T., Protheroe, R., & Childs, C. (2006). Body temperature management after severe traumatic brain injury: Methods and protocols used in the United Kingdom and Ireland. Resuscitation, 70 (2), 254-262. http://dx.doi.org/10.1016/j.resuscitation.2006.02.010
  15. Kallmunzer, B., Krause, C., Pauli, E., Beck, A., Breuer, L., Kohrmann, M., et al. (2011). Standardized antipyretic treatment in stroke: A pilot study. Cerebrovascular Disease, 31 (4), 382-389. https://doi.org/10.1159/000321733
  16. Kaz Europe, S. A. (2011). Braun IRT Thermosacan Operation Manual. Seoul: Kaz Europe SA.
  17. Kiekkas, B. P., Brokalaki, H., Theodorakopoulou, G., & Baltopoulos, G. I. (2008). Physical antipyresis in critically ill adults. American Journal of Nursing, 108 (7), 40-49.
  18. Kilpatrick, M. M., Lowry, D. W., Firlik, A. D., Yonas, H., & Marion, D. W. (2000). Hyperthermia in the neurosurgical intensive care unit. Neurosurgery, 47, 850-856. https://doi.org/10.1097/00006123-200010000-00011
  19. Loke, A. Y., Chan, H. C., & Chan, T. M. (2005). Comparing the effectiveness of two types of cooling blankets for febrile patients. Nursing in Critical Care, 10 (5), 247-254. http://dx.doi.org/10.1111/j.1362-1017.2005.00133.x
  20. Lu, S. H., Leasure, A. R., & Dai, Y. T. (2009). A systematic review of body temperature variations in older people. Journal of Clinical Nursing, 19 (1-2), 4-16. http://dx.doi.org/10.1111/j.1365-2702.2009.02945.x
  21. O'Grady, N. P., Barie, P. S., Bartlett, J. G., Bleck, T., Carroll, K., Kalil, A. C., et al. (2008). Guidelines for evaluation of new fever in critically ill adult patients: 2008 Update from the American College of Critical Care Medicine and the Infectious Diseases Society of America. Critical Care Medicine, 36 (4), 1330-1349. https://doi.org/10.1097/CCM.0b013e318169eda9
  22. Onur, O. E., Guneysel, O., Akoglu, H., Aydin, Y. D., & Denizbasi, A. (2008). Oral, axillary, and tympanic temperature measurements in older and younger adults with or without fever. European Journal of Emergency Medicine, 15 (6), 334-337. https://doi.org/10.1097/MEJ.0b013e3283036cfe
  23. Schneller, L.-E. (2010). Observations and vital Signs. Consumer Information Sheet, 1-4. Retrieved from http://connect.jbiconnectplus.org/ViewPdf.aspx?0=4034&1=8
  24. Scottish Intercollegiate Guidelines Network. (2008). SIGN 50; A guideline developer handbook scottish intercollegiate guidelines network (Ed.) Retrieved from http://www.sign.ac.uk/guidelines/fulltext/50/annexb.html
  25. Sund-Levander, M., Forsberg, C., & Wahren, L. K. (2002). Normal oral, rectal, tympanic and axillary body temperature in adult men and women: A systematic literature review. Scandinavian Journal of Caring Sciences, 16 (2), 122-128. http://dx.doi.org/10.1046/j.1471- 6712.2002.00069.x
  26. Thompson, H. J. (2005). Fever: A concept analysis. Journal of Advanced Nursing, 51 (5), 484-492. http://dx.doi.org/10.1111/j.1365-2648.2005.03520.x
  27. Thompson, H. J., & Kagan, S. H. (2011). Clinical management of fever by nurses: Doing what works. Journal of Advanced Nursing, 67 (2), 359-370. http://dx.doi.org/10.1111/j.1365-2648.2010.05506.x
  28. Thompson, H. J., Kirkness, C. J., Mitchell, P. H., & Webb, D. J. (2007). Fever management practices of neuroscience nurses: National and regional perspectives. Journal of Neuroscience Nursing, 39 (3), 151-162. https://doi.org/10.1097/01376517-200706000-00005
  29. Vermeulen, H., Storm-Versloot, M. N., Goossens, A., Speelman, P., & Legemate, D. A. (2005). Diagnostic accuracy of routine postoperative body temperature measurements. Clinical Infectious Diseases, 40 (10), 1404-1410. https://doi.org/10.1086/429621
  30. Watts, R., & Robertson, J. (2011). Non-pharmacological management of fever in children. Retrieved May 6, 2012, from The Joanna Briggs Institute http://www.joannabriggslibrary.org/index.php/jbisrir/article/view/316

Cited by

  1. Tepid massage for febrile children: A systematic review and meta-analysis vol.24, pp.5, 2018, https://doi.org/10.1111/ijn.12649
  2. Performance and Influencing Factors of Evidence-Based Pressure Ulcer Care Among Acute Care Hospital Nurses vol.16, pp.1, 2019, https://doi.org/10.1111/wvn.12348
  3. 초중고 학교구성원들의 MERS(MERS-CoV) 대처경험: 컨트롤타워 부재속에서 학교 재량으로 대응하기 vol.28, pp.3, 2013, https://doi.org/10.15434/kssh.2015.28.3.188
  4. 성인 뇌 손상 발열 중환자를 위한 체온 중재 지침 개발 vol.22, pp.3, 2013, https://doi.org/10.22650/jkcnr.2016.22.3.265
  5. Effect of the Fever Education Program on Pediatric Nurses' Expert Knowledge, Attitudes and Nursing Practice vol.21, pp.2, 2017, https://doi.org/10.21896/jksmch.2017.21.2.149
  6. Critical Review I to Standardize the Textbooks of Fundamentals of Nursing: Vital Sign Assessment, Body Temperature Regulation, Oxygenation vol.26, pp.4, 2019, https://doi.org/10.7739/jkafn.2019.26.4.282
  7. 근거기반 정맥주입요법 간호실무지침 실무적용 프로그램 개발 및 평가 - 중소병원을 대상으로 vol.50, pp.6, 2013, https://doi.org/10.4040/jkan.20196