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Fever Management Practices of Neuroscience Nurses: National and Regional Perspectives

Thompson, Hilaire J.; Kirkness, Catherine J.; Mitchell, Pamela H.; Webb, Deborah J.

Journal of Neuroscience Nursing: June 2007 - Volume 39 - Issue 3 - p 151–162
Article

Neuroscience patients with fever may have worse outcomes than those who are afebrile. However, neuroscience nurses who encounter this common problem face a translational gap between patient‐outcomes research and bedside practice because there is no current evidence‐based standard of care for fever management of the neurologically vulnerable patient. The aim of this study was to determine if there are trends in national practices for fever and hyperthermia management of the neurologically vulnerable patient. A 15‐item mailed questionnaire was used to determine national and regional trends in fever and hyperthermia management and decision making by neuroscience nurses. Members of the American Association of Neuroscience Nurses were surveyed (N = 1,225) and returned 328 usable surveys. Fewer than 20% of respondents reported having an explicit fever management protocol in place for neurologic patients, and 12.5% reported having a nonspecific patient protocol available for fever management. Several clear and consistent patterns in interventions for fever and hyperthermia management were seen nationally, including acetaminophen administration at a dose of 650 mg every 4 hours, ice packs, water cooling blankets, and tepid bathing. However, regional differences were seen in intervention choices and initial temperature to treat.

Questions or comments about this article may be directed to Hilaire J. Thompson, PhD APRN BC CNRN, at hilairet@u.washington.edu. She is a Claire M. Fagin Fellow, John A. Hartford Foundation, National Institutes of Health Roadmap Multidisciplinary Clinical Research Scholar and assistant professor at the School of Nursing at the University of Washington, Seattle, WA.

Catherine J. Kirkness, PhD RN, is a research associate professor at the School of Nursing at the University of Washington, Seattle, WA.

Pamela H. Mitchell, PhD RN CNRN FAAN FAHA, is a Soule Distinguished Professor and associate dean for research at the School of Nursing at the University of Washington, Seattle, WA.

Deborah J. Webb, MSN RN CNRN, is a clinical nurse specialist at Harborview Medical Center, Seattle, WA.

© 2007 American Association of Neuroscience Nurses