Thompson Hilaire J, Kirkness Catherine J, Mitchell Pamela H
Department of Biobehavioral Nursing and Health Systems at the University of Washington, Seattle, WA, USA.
J Neurosci Nurs. 2007 Aug;39(4):196-201. doi: 10.1097/01376517-200708000-00002.
Fever is frequently encountered by neuroscience nurses in patients with neurological insults and often results in worsened patient outcomes when compared with similar patients who do not have fever. Best practices in fever management are then essential to optimizing patient outcomes. Yet the topic of best nursing practices for fever management is largely ignored in the clinical and research literature, which can complicate the achievement of best practices. A national survey to gauge fever management practices and decision making by neuroscience nurses was administered to members of the American Association of Neuroscience Nurses. Results of the questionnaire portion of the survey were previously published. This report presents a content analysis of the responses of neuroscience nurses to the open-ended-question portion of the survey (n = 106), which revealed a dichotomous primary focus on nursing- or patient-related issues. In addition, respondents described barriers and issues in the provision of fever-management care to neuroscience patients. In order to advance national best practices for fever management in neurologically vulnerable patients, further work needs to be conducted, particularly with regard to necessary continuing education for staff, facilitation of interdisciplinary communication, and development of patient care protocols. Neuroscience nurses are in an excellent position to provide leadership in these areas.
神经科学护士在患有神经损伤的患者中经常遇到发热情况，与未发热的类似患者相比，发热往往会导致患者预后恶化。因此，发热管理的最佳实践对于优化患者预后至关重要。然而，临床和研究文献在很大程度上忽略了发热管理的最佳护理实践这一主题，这可能会使实现最佳实践变得复杂。对美国神经科学护士协会的成员进行了一项全国性调查，以评估神经科学护士的发热管理实践和决策。该调查问卷部分的结果此前已发表。本报告对神经科学护士对调查开放式问题部分（n = 106）的回答进行了内容分析，结果显示主要集中在护理相关或患者相关问题这两个方面。此外，受访者描述了在为神经科学患者提供发热管理护理方面的障碍和问题。为了推进针对神经功能脆弱患者的全国性发热管理最佳实践，需要开展进一步的工作，特别是在员工必要的继续教育、促进跨学科交流以及制定患者护理方案方面。神经科学护士在这些领域处于极佳的领导地位。
