Schafer Dorothea, Boogaart Sheri, Johnson Lynette, Keezel Catherine, Ruperts Liga, Vander Laan Karen J
Neonatal Services, Helen DeVos Children's Hospital, Spectrum Health Medical Center, Grand Rapids, Michigan (Mss Schafer, Boogaart, Johnson, Keezel, and Ruperts); and Nursing Practice & Development, Spectrum Health Hospitals, Grand Rapids, Michigan (Dr Vander Laan).
Adv Neonatal Care. 2014 Feb;14(1):52-60. doi: 10.1097/ANC.0000000000000027.
Appropriate thermoregulation affects both morbidity and mortality in the neonatal setting. Nurses rely on information from temperature sensors and radiant warmers or incubators to appropriately maintain a neonate's body temperature. Skin temperature sensors must be repositioned to prevent skin irritation and breakdown. This study addresses whether there is a significant difference between skin sensor temperature readings from 3 locations on the neonate and whether there is a significant difference between skin sensor temperatures compared with digital axillary temperatures.
The study participants included 36 hemodynamically stable neonates, with birth weight of 750 g or more and postnatal age of 15 days or more, in a neonatal intensive care unit. Gestational age ranged from 29.6 to 36.1 weeks at the time of data collection.
A method-comparison design was used to evaluate the level of agreement between skin sensor temperatures and digital axillary thermometer measurements.
When the neonate's skin sensor was scheduled for routine site change, 3 new skin sensors were placed-1 each on the right upper abdomen, left flank, and right axilla. The neonate was placed in a supine position and redressed or rewrapped if previously dressed or wrapped. Subjects served as their own controls, with temperatures measured at all 3 skin sensor sites and followed by a digital thermometer measurement in the left axilla. The order of skin sensor temperature measurements was randomly assigned by a computer-generated number sequence.
An analysis of variance for repeated measures was used to test for statistical differences between the skin sensor temperatures. The difference in axillary and skin sensor temperatures was calculated by subtracting the reference standard temperature (digital axillary) from the test temperatures (skin temperatures at 3 different locations), using the Bland-Altman method. The level of significance was set at P < .05.
No statistically significant differences were found between skin temperature readings obtained from the 3 sites (F2,70 = 2.993, P = .57). Differences between skin temperature readings and digital axillary temperature were also not significant when Bland-Altman graphs were plotted.
For hemodynamically stable neonates in a supine position, there were no significant differences between skin sensor temperatures on abdomen, flank, or axilla or between skin sensor temperatures and a digital axillary temperature. This may increase nurses' confidence that various sites will produce accurate temperature readings.
在新生儿护理中，适当的体温调节对发病率和死亡率均有影响。护士依靠温度传感器以及辐射保暖台或暖箱的信息来适当维持新生儿的体温。皮肤温度传感器必须重新放置以防止皮肤刺激和破损。本研究探讨新生儿身上3个部位的皮肤传感器温度读数之间是否存在显著差异，以及与数字式腋温相比，皮肤传感器温度之间是否存在显著差异。
研究参与者包括新生儿重症监护病房中36名血流动力学稳定的新生儿，出生体重750克及以上，出生后年龄15天及以上。数据收集时，胎龄范围为29.6至36.1周。
采用方法比较设计来评估皮肤传感器温度与数字式腋温测量之间的一致性水平。
当新生儿的皮肤传感器按计划进行常规部位更换时，放置3个新的皮肤传感器，右上腹、左胁腹和右腋窝各放置1个。将新生儿置于仰卧位，若之前已穿衣或包裹则重新穿衣或包裹。受试者作为自身对照，测量所有3个皮肤传感器部位的温度，随后用数字体温计测量左腋窝温度。皮肤传感器温度测量顺序由计算机生成的数字序列随机分配。
采用重复测量方差分析来检验皮肤传感器温度之间的统计学差异。使用Bland-Altman方法，通过从测试温度（3个不同部位的皮肤温度）中减去参考标准温度（数字式腋温）来计算腋温和皮肤传感器温度之间的差异。显著性水平设定为P <.05。
从3个部位获得的皮肤温度读数之间未发现统计学显著差异（F2,70 = 2.993，P =.57）。绘制Bland-Altman图时，皮肤温度读数与数字式腋温之间的差异也不显著。
对于仰卧位的血流动力学稳定的新生儿，腹部、胁腹或腋窝的皮肤传感器温度之间，以及皮肤传感器温度与数字式腋温之间均无显著差异。这可能会增加护士对不同部位均可产生准确温度读数的信心。
