title: Improving Pediatric Temperature Measurement in the ED.
abstract: ED care providers have long debated which of the various methods of temperature measurement of pediatric patients is best. While the efficacy and accuracy of temporal artery, tympanic membrane, axillary, and infrared temperature measurement have been studied, the gold standard has been rectal temperature measurement. But despite its accuracy, this method causes children with noninfectious complaints and their families unnecessary distress and adds significant time to the triage process. In response, a group of ED staff nurses at a multihospital health system conducted an evidence-based quality improvement project to determine the best practice for accurate temperature measurement in children younger than five years who presented to the ED. The project included an exhaustive literature search, a review of relevant studies, the development of a table of evidence, a presentation of the findings, and recommendations for practice change. This article describes the project and the adoption of temporal artery thermometry, a painless, noninvasive screening method that provided consistently accurate temperature measurement as well as increased patient and nurse satisfaction and a shorter triage process.
authors: Beth Hurwitz is a staff nurse at Einstein Medical Center and Joanne Brown is a staff nurse at Einstein Healthcare Network, both in Philadelphia. Gerry Altmiller is a clinical nurse specialist consultant at Einstein Healthcare Network and an associate professor at the College of New Jersey in Ewing Township. Contact author: Beth Hurwitz, bkriegerrn@comcast.net. The authors have disclosed no potential conflicts of interest, financial or otherwise.
authors: Beth
authors: B
authors: Hurwitz
authors: Joanne
authors: J
authors: Brown
authors: Gerry
authors: G
authors: Altmiller
mesh_terms: D001831:Body Temperature / Q000502:physiology; D002675:Child, Preschool; D015400:Clinical Nursing Research; D004636:Emergency Service, Hospital; D055318:Evidence-Based Nursing; D005334:Fever / Q000175:diagnosis* / Q000451:nursing; D006801:Humans; D007223:Infant; D019982:Organizational Case Studies; D010372:Pediatrics / Q000379:methods; D013699:Temporal Arteries / Q000502:physiology*; D062125:Thermometry / Q000295:instrumentation / Q000379:methods / Q000451:nursing*; D014218:Triage / Q000379:methods / Q000592:standards