title: Comparison of temporal to pulmonary artery temperature in febrile patients.
abstract: BACKGROUND
  As a routine part of clinical care, temperature measurement is a key indicator of illness. With the criterion standard of temperature measurement from the pulmonary artery catheter thermistor (PAT), which insertion of PAT carries significant risk to the patient, a noninvasive method that is accurate and precise is needed.
  
  
  OBJECTIVE
  The purpose of this study was to measure the precision and accuracy of 2 commonly used methods of collecting body temperature: PAT considered the criterion standard and the temporal artery thermometer (TAT) in those patients with a temperature greater than 100.4°F.
  
  
  METHODS
  This is a repeated-measures design with each patient with a PAT in the intensive care unit acting as their own control to investigate the difference in PAT readings and readings from TAT in the core mode. Accuracy and precision were analyzed.
  
  
  RESULTS
  There were 60 subjects, 41 males and 19 females, with mean age of 60.8 years, and 97% (n = 58) were post-cardiac surgery. There was a statistically significant difference between PAT and TAT (101.0°F [SD, 0.5°F] vs 100.5°F [SD, 0.8°F]; bias, -0.49°F; P < .001). Differences in temperature between the 2 methods were clinically significant (ie, >0.9°F different) in 15 of 60 cases (25%). No TAT measurements were 0.9 F greater than the corresponding PAT measurement (0%; 95% confidence interval, 0%-6%).
  
  
  CONCLUSIONS
  These data demonstrate the accuracy of TAT when compared with PAT in those with temperatures of 100.4°F or greater. This study demonstrates that TAT set to core mode is accurate with a 0.5°F lower temperature than PAT. There was 25% in variability in precision of TAT.
authors.affiliation: Donna Furlong, RN, is staff nurse at the Cardiac Surgical Intensive Care Unit, Massachusetts General Hospital, Boston. Ms Donna has been a staff nurse for 34 years in this unit. Diane L. Carroll, PhD, RN, FAAN, is nurse researcher, Munn Center for Nursing Research, Massachusetts General Hospital, Boston. Dr Carroll has been the nurse researcher for the past 7 years and previously a clinical nurse specialist. Cynthia Finn, RN, is staff nurse at the Cardiac Surgical Intensive Care Unit, Massachusetts General Hospital, Boston. Ms Finn has been a staff nurse for 29 years in this unit. Diane Gay, RN, is staff nurse at the Cardiac Surgical Intensive Care Unit, Massachusetts General Hospital, Boston. Ms Gay has been a nurse in this unit for 31 years. Christine Gryglik, PhD(c), RN, is former clinical nurse specialist at the Cardiac Surgical Intensive Care Unit, Massachusetts General Hospital, Boston. Mr Gryglik is a doctoral candidate at the University of Massachusetts. Vivian Donahue, MSN, RN, is nurse director at the Cardiac Surgical Intensive Care Unit, Massachusetts General Hospital, Boston. Ms Donahue has been the nurse director in this unit for the past 4 years and previously a clinical nurse specialist.
authors.forename: Donna
authors.initials: D
authors.lastname: Furlong
authors.forename: Diane L
authors.initials: DL
authors.lastname: Carroll
authors.forename: Cynthia
authors.initials: C
authors.lastname: Finn
authors.forename: Diane
authors.initials: D
authors.lastname: Gay
authors.forename: Christine
authors.initials: C
authors.lastname: Gryglik
authors.forename: Vivian
authors.initials: V
authors.lastname: Donahue
mesh_terms: D001831:Body Temperature; D006348:Cardiac Surgical Procedures; D005260:Female; D005334:Fever; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery; D013699:Temporal Arteries; D013817:Thermography / Q000379:methods*