PURPOSE The aim of this study was to investigate the accuracy of infrared temperature measurements compared to axillary temperature in order to detect fever in patients. METHODS Studies published between 1946 and 2012 from periodicals indexed in Ovid Medline, Embase, CINAHL, Cochrane, KoreaMed, NDSL, KERIS and other databases were selected using the following key words: "infrared thermometer." QUADAS-II was utilized to assess the internal validity of the diagnostic studies. Selected studies were analyzed through a meta-analysis using MetaDisc 1.4. RESULTS Twenty-one diagnostic studies with high methodological quality were included representing 3,623 subjects in total. Results of the meta-analysis showed that the pooled sensitivity, specificity, and area under the curve (AUC) of infrared tympanic thermometers were 0.73 (95% CI 0.70~0.75), 0.92 (95% CI 0.91~0.92), and 0.90, respectively. For axillary temperature readings, the pooled sensitivity was 0.67 (95% CI 0.62~0.73), the pooled specificity was 0.87 (95% CI 0.85~0.90), and the AUC was 0.80. CONCLUSION Infrared tympanic temperature can predict axillary temperature in normothermic and in febrile patients with an acceptable level of diagnostic accuracy. However, further research is necessary to substantiate this finding in patients with hyperthermia.
PURPOSE This study was designed to develop, to implement and evaluate a fever management nursing protocol for adult patients. METHODS This study was conducted through seven steps following both the guideline development procedures of the Scottish Intercollegiate Guidelines Network and the Model of the Asan Medical Center Evidence-Based Practice, as follows: 1) identifying the clinical needs and composition of the protocol development group; 2) identifying and evaluating the evidence; 3) assessing the level of evidence and grading recommendations; 4) forming a protocol; 5) evaluating the protocol using an expert group validity test and identifying barriers to its implementation; 6) protocol development; and 7) evaluation of practical improvement measures following implementation of the protocol. RESULTS The evidence-based protocol for fever management in adult patients was completed and includes five domains and 15 items. The protocol had good content validity (CVI=.90) and nursing practice could be improved after implementation of the protocol. CONCLUSION This nursing protocol can be used as a guide for nursing in febrile adult patients. We recommend that further guidelines be updated in an interdisciplinary manner in order to foster local adaptation of the best clinical practices.
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