Nurse practitioners' treatment of febrile infants in Utah: comparison to physician practice nationally.
OBJECTIVE
To determine nurse practitioners' (NPs') knowledge of published guidelines involving the treatment of infants with fever without a source and to compare the practice of NPs in Utah to physicians nationally.


METHODS
Using a comparative descriptive design, a survey was sent to 450 NPs in Utah replicating the methodology of a 1998 survey of physicians. The NPs were asked about their evaluation decisions and management strategies for various ages of infants/toddlers with fever without a source.


CONCLUSIONS
The practice decisions of NPs in Utah and physicians nationally were similar. Family NPs' clinical decisions aligned more closely with family practice medical doctors and pediatric NPs' with pediatricians. Overall, the younger the patient, the more likely were NPs to order labs and antibiotics or to hospitalize/refer to a physician. The fact that management decisions were not based upon existing protocols may account for the practice variation seen among NPs.


CONCLUSIONS
Management of a febrile infant is a common clinical scenario for the primary care provider. Although evidence-based protocols exist, the treatment of febrile infants remains controversial. Overall, NPs' evaluation and management of these infants were not shown to differ from physicians. Further studies are needed to determine why clinical guidelines are not being followed.
Badger
Matthew J
MJ
College of Nursing, Brigham Young University, Provo, UT, USA.
Lookinland
Sandra
S
Tiedeman
Mary
M
Anderson
Vickie
V
Eggett
Dennis
D
D000367:Age Factors; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004363:Drug Utilization; D004521:Educational Measurement; D019317:Evidence-Based Medicine; D022143:Family Nursing / Q000379:methods / Q000706:statistics & numerical data; D005335:Fever of Unknown Origin / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D019983:Guideline Adherence / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006801:Humans; D007223:Infant; D009722:Nurse Practitioners / Q000193:education* / Q000706:statistics & numerical data*; D015403:Nursing Evaluation Research; D010371:Pediatric Nursing / Q000379:methods / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000379:methods / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014589:Utah
D000900:Anti-Bacterial Agents