성인 발열환자의 발열관리 실태 조사
A Descriptive Study for Fever Management in Adult Febrile Patients
0
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Purpose: The specific aims of this study were to define fever from the nurse’s and physician’s perspectives,describe fever management method and decision-making, and identify differences of definition of fever and fever managements between nurses and physicians. Methods: A cross-sectional survey using a 23-item questionnaire was used. A total of 305 nurses and physicians were surveyed, and 246 useful questionnaires were returned. Results: Body temperature of 36.5~38.3 were considered as adult febrile, and fever managements were initiated when the temperature was 37.0~38.0 . More than half of the nurses and physicians, made a clinical decision regarding fever managements based on their own experiences. The most frequently used interventions in nursing practice were antipyretics, intravenous hydration, and external cooling. Nurses provided external cooling to lower body temperature than physicians (Z=-4.67, p<.001). Most participants reported that they needed a fever management protocol. Conclusion: Based on the information obtained,nurses respond with sensitivity to lower body temperature. We found significant differences among nurses,between nurses and physicians in approaching care of adult febrile patients.
Abstract
Purpose: The specific aims of this study were to define fever from the nurse’s and physician’s perspectives,describe fever management method and decision-making, and identify differences of definition of fever and fever managements between nurses and physicians. Methods: A cross-sectional survey using a 23-item questionnaire was used. A total of 305 nurses and physicians were surveyed, and 246 useful questionnaires were returned. Results: Body temperature of 36.5~38.3 were considered as adult febrile, and fever managements were initiated when the temperature was 37.0~38.0 . More than half of the nurses and physicians, made a clinical decision regarding fever managements based on their own experiences. The most frequently used interventions in nursing practice were antipyretics, intravenous hydration, and external cooling. Nurses provided external cooling to lower body temperature than physicians (Z=-4.67, p<.001). Most participants reported that they needed a fever management protocol. Conclusion: Based on the information obtained,nurses respond with sensitivity to lower body temperature. We found significant differences among nurses,between nurses and physicians in approaching care of adult febrile patients.
참고문헌 (30)
- Alves, J. G., "Tepid sponging plus dipyrone versus dipyrone alone for reducing body temperature in febrile children", Sao Paulo Medical Journal, 126(2), pp.107~111 (2008)
- Asan Medical Center, "AMC model of evidence-based practice" (2010), Asan Medical Center
- Axelrod, P., "External cooling in the management of fever", Clinical Infectious Diseases, 31(Suppl 5), pp.S224~229 (2000)
- Beard, R. M., "Fever and hyperthermia: Learn to beat the heat", Nursing, 38(6), pp.28~31 (2008)[DOI]
- Brain Trauma Foundation, "Guidelines for the management of severe traumatic brain injury", Journal of Neurotrauma, 24(Suppl 1), pp.S1~S106 (2007)
- Broessner, G., "Prophylactic, endovascularly based, long-term normothermia in ICU patients with severe cerebrovascular disease: Bicenter prospective, randomized trial", Stroke, 40(12), pp.e657~665 (2009)[DOI]
- Edwards, H. E., "Fever management practises : What pediatric nurses say", Nursing and Health Sciences, 3(3), pp.119~130 (2001)
- Greer, D. M., "Impact of fever on outcome in patients with stroke and neurologic injury: A comprehensive metaanalysis", Stroke, 39(11), pp.3029~3035 (2008)[DOI]
- Hammond, N. E., "Pharmacological versus non-pharmacological antipyretic treatments in febrile critically ill adult patients: A systematic review and metaanalysis", Australian Critical Care, 24(1), pp.4~17 (2011)[DOI]
- Henker, R., "Fever : Applying research to bedside practice", AACN Advanced Critical Care, 18(1), pp.76~87 (2007)
- High, K. P., "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), pp.375~394 (2009)[DOI]
- Isaacs, S. N., "Antipyretic orders in a university hospital", The American Journal of Medicine, 88(1), pp.31~35 (1990)
- 정용선, "아동의 발열과 발열관리: 문헌고찰", Child Health Nursing Research, 16(1), pp.30~40 (2010), 아동간호학회
- Karwowska, A., "Parental and health care provider understanding of childhood fever : A Canadian perspective", Canadian Journal of Emergency Medicine, 4(6), pp.394~400 (2002)
- Kiekkas, B. P., "Physical antipyresis in critically ill adults", The American Journal of Nursing, 108(7), pp.40~49 (2008)[DOI]
- Lee, E. O., "Nursing Research and Statistical Analysis" (2009), Soomoonsa
- Lu, S. H., "A systematic review of body temperature variations in older people", Journal of Clinical Nursing, 19(1-2), pp.4~16 (2009)[DOI]
- McGowan, J. E., "Fever in hospitalized patients. With special reference to the medical service", The American Journal of Medicine, 82(3 Spec No), pp.580~586 (1987)
- "NICE clinical guideline 47. Feverish illness in children: Assessment and initial management in children younger than 5 years. Retrieved Nobember 20, 2012" (2007)[URL]
- O'Donnell, J., "Use and effectiveness of hypothermia blankets for febrile patients in the intensive care unit", Clinical Infectious Diseases, 24(6), pp.1208~1213 (1997)
- O'Grady, N. P., "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), pp.1330~1349 (2008)[DOI]
- Onur, O. E., "Oral, axillary, and tympanic temperature measurements in older and younger adults with or without fever", European Journal of Emergency Medicine, 15(6), pp.334~337 (2008)[DOI]
- Schmitz, T., "A comparison of five methods of temperature measurement in febrile intensive care patients", American Journal of Critical Care, 4(4), pp.286~292 (1995)
- "Observations and Vital Signs. Consumer Information Sheet, 1-4. Retrieved May 10, 2011" (2010)[URL]
- "SIGN 50: A guideline developer's handbook. Retrieved September 9, 2012" (2011)[URL]
- Thompson, H. J., "Fever : A concept analysis", Journal of Advanced Nursing, 51(5), pp.484~492 (2005)
- Thompson, H. J., "Clinical management of fever by nurses : Doing what works", Journal of Advanced Nursing, 67(2), pp.359~370 (2011)[DOI]
- Thompson, H. J., "Fever management practices of neuroscience nurses : National and regional perspectives", The Journal of Neuroscience Nursing, 39(3), pp.151~162 (2007)
- Vermeulen, H., "Diagnostic accuracy of routine postoperative body temperature measurements", Clinical Infectious Diseases, 40(10), pp.1404~1410 (2005)
- Walsh, A. M., "Fever management : Paediatric nurses' knowledge, attitudes and influencing factors", Journal of Advanced Nursing, 49(5), pp.453~464 (2005)