Hu Fei, Zhang Jiayan, Shi Shupeng, Zhou Zhang
Children's Hospital of Fudan University, Shanghai, People's Republic of China.
JBI Database System Rev Implement Rep. 2016 Sep;14(9):358-366. doi: 10.11124/JBISRIR-2016-003072.
Febrile illness in young children usually indicates an underlying infection and is a cause of concern for parents and carers. It is very important that healthcare professionals know how to recognize fever, assess children with fever, treat children with fever and role of nurses and parents. This paper outlines a best practice implementation project on the management of fever in children in an emergency department.
To audit current practice of fever management for children in an emergency department and to implement strategies to standardize pediatric fever management based on evidence-based practice guidelines.
We used the Joanna Briggs Institute's Practical Application of Clinical Evidence System and Getting Research into Practice to examine compliance with fever management criteria based on the best available evidence before and after the implementation of strategies to spread the use of evidence-based practice protocols.
We found significant improvements in pediatric fever management as measured by the knowledge scores of parents (54.5-83.7) and nurses (67.6-90.3). This suggested a need for continuous education. We found a noticeable improvement in compliance across all the five criteria; using correct methods to measure temperature (86-98%), staff education (0-100%), parents education (0-100%), using assessment tools (0-100%) and observed management (0-98%).
This best practice implementation project demonstrated the use of effective strategies to standardize the protocol for fever management, implement assessment tool, develop multimedia materials, deliver continuous staff education and update nursing documentation and patient education pamphlets to ensure best practice is delivered by nurses to improve patient outcomes.
幼儿发热性疾病通常提示潜在感染，这是家长和护理人员关注的问题。医疗保健专业人员了解如何识别发热、评估发热儿童、治疗发热儿童以及护士和家长的作用非常重要。本文概述了急诊科儿童发热管理的最佳实践实施项目。
审核急诊科儿童发热管理的当前实践，并根据循证实践指南实施标准化儿科发热管理的策略。
我们使用乔安娜·布里格斯研究所的临床证据系统实际应用和将研究转化为实践，在实施推广循证实践方案使用的策略前后，根据现有最佳证据检查发热管理标准的依从性。
通过家长（54.5 - 83.7）和护士（67.6 - 90.3）的知识得分衡量，我们发现儿科发热管理有显著改善。这表明需要持续教育。我们发现所有五个标准的依从性都有明显改善；使用正确方法测量体温（86 - 98%）、员工教育（0 - 100%）、家长教育（0 - 100%）、使用评估工具（0 - 100%）和观察到的管理（0 - 98%）。
这个最佳实践实施项目展示了使用有效策略来标准化发热管理方案、实施评估工具、开发多媒体材料、提供持续的员工教育以及更新护理文件和患者教育手册，以确保护士提供最佳实践，改善患者结局。
