Developing An Evidence-Based Standard Of Practice For Acute-Care Nursing Management Of Fever In HIV/Aids

2.50
Hdl Handle:
http://hdl.handle.net/10755/163796
Category:
Abstract
Type:
Presentation
Title:
Developing An Evidence-Based Standard Of Practice For Acute-Care Nursing Management Of Fever In HIV/Aids
Author(s):
Jones, Sande
Author Details:
Sande Jones, PhD, Assistant Professor, Florida International University, School of Nursing, North Miami, Florida, USA, email: joness@fiu.edu
Abstract:
Problem: Temperature elevation and fever are common occurrences for hospitalized HIV/AIDS patients, regardless of the admitting diagnosis (Holtzclaw, 1995). Research has shown that acute-care nurses independently assess fever and make decisions regarding fever management (Grossman, Keen, Singer & Asher,1995). A Clinical Nurse Specialist /Practitioner was asked to develop an evidence-based standard of nursing practice for HIV/AIDS fever management for a medical HIV/AIDS/Infectious Disease unit. The purpose of this presentation is to discuss the project's development and implementation. Method Of Review: A review of CINAHL, MEDLINE, and STTI's Registry of Nursing Research was conducted to first determine what was known in relation to nursing fever care for HIV/AIDS. The review revealed that the management of fever is controversial in both the nursing and medical literature. The review also revealed limited research on nursing care of AIDS fever, or fever in the non-ICU setting. Practice Innovation: To gather initial data, pilot studies were conducted after IRB approval. A review of the medical records of hospitalized HIV/AIDS patients revealed that temperature elevation and fever were common occurrences, although the fever was often self-limiting. The study also revealed that HIV/AIDS patients with fever did not exhibit an elevation in white blood cell, making fever in HIV/AIDS differ from the classical picture of fever observed in other types of medical-surgical patients. This validated HIV/AIDS fever as a unique phenomena and an important area for nursing research in the practice setting. To understand the experience from the patients' perspective, a qualitative study was conducted to determine hospitalized HIV/AIDS patients' perceptions of the experience of fever. A study utilizing Grossman and Keen's (1995) open-ended Fever Survey was then done to determine the multi-ethnic staff nurses' current practice for fever care. Implemention/Evaluation: Analysis of study findings revealed that patients described fever in terms of heat and discomfort, and staff nurses used antipyretics plus various physical cooling methods for fever management. A pilot study was then conducted to determine the effectiveness of antipyretics versus antipyretics combined with an innovative method, a "cooling scarf" placed around the patient's neck. Outcomes: Both interventions were significant for temperature (Tylenol, t=5.556, df=9,p=.000; Tylenol plus cooling scarf, t=9.494, df=9, p= .000 ) and comfort level (Tylenol, t =5.896, df=9, p=.000; Tylenol plus cooling scarf, t =5.075, df = 9, p=.001). Use of a simple sign test (+ and -) to denote pre- and post-change revealed that Tylenol combined with a cooling scarf produced both the greatest decrease in temperature, and greatest increase in comfort. The "cooling scarf" intervention was added to the standard of practice, and the study is continuing with a larger sample. Lessons Learned: A simple request to develop an evidence-based standard of practice evolved into a five-year project. However, the AIDS fever project resulted in staff nurses' interest in using research to determine "best practice" in nursing.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2001
Conference Name:
ENRS 13th Annual Scientific Sessions
Conference Host:
Eastern Nursing Research Society
Conference Location:
Atlantic City, New Jersey, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleDeveloping An Evidence-Based Standard Of Practice For Acute-Care Nursing Management Of Fever In HIV/Aidsen_GB
dc.contributor.authorJones, Sandeen_US
dc.author.detailsSande Jones, PhD, Assistant Professor, Florida International University, School of Nursing, North Miami, Florida, USA, email: joness@fiu.eduen_US
dc.identifier.urihttp://hdl.handle.net/10755/163796-
dc.description.abstractProblem: Temperature elevation and fever are common occurrences for hospitalized HIV/AIDS patients, regardless of the admitting diagnosis (Holtzclaw, 1995). Research has shown that acute-care nurses independently assess fever and make decisions regarding fever management (Grossman, Keen, Singer & Asher,1995). A Clinical Nurse Specialist /Practitioner was asked to develop an evidence-based standard of nursing practice for HIV/AIDS fever management for a medical HIV/AIDS/Infectious Disease unit. The purpose of this presentation is to discuss the project's development and implementation. Method Of Review: A review of CINAHL, MEDLINE, and STTI's Registry of Nursing Research was conducted to first determine what was known in relation to nursing fever care for HIV/AIDS. The review revealed that the management of fever is controversial in both the nursing and medical literature. The review also revealed limited research on nursing care of AIDS fever, or fever in the non-ICU setting. Practice Innovation: To gather initial data, pilot studies were conducted after IRB approval. A review of the medical records of hospitalized HIV/AIDS patients revealed that temperature elevation and fever were common occurrences, although the fever was often self-limiting. The study also revealed that HIV/AIDS patients with fever did not exhibit an elevation in white blood cell, making fever in HIV/AIDS differ from the classical picture of fever observed in other types of medical-surgical patients. This validated HIV/AIDS fever as a unique phenomena and an important area for nursing research in the practice setting. To understand the experience from the patients' perspective, a qualitative study was conducted to determine hospitalized HIV/AIDS patients' perceptions of the experience of fever. A study utilizing Grossman and Keen's (1995) open-ended Fever Survey was then done to determine the multi-ethnic staff nurses' current practice for fever care. Implemention/Evaluation: Analysis of study findings revealed that patients described fever in terms of heat and discomfort, and staff nurses used antipyretics plus various physical cooling methods for fever management. A pilot study was then conducted to determine the effectiveness of antipyretics versus antipyretics combined with an innovative method, a "cooling scarf" placed around the patient's neck. Outcomes: Both interventions were significant for temperature (Tylenol, t=5.556, df=9,p=.000; Tylenol plus cooling scarf, t=9.494, df=9, p= .000 ) and comfort level (Tylenol, t =5.896, df=9, p=.000; Tylenol plus cooling scarf, t =5.075, df = 9, p=.001). Use of a simple sign test (+ and -) to denote pre- and post-change revealed that Tylenol combined with a cooling scarf produced both the greatest decrease in temperature, and greatest increase in comfort. The "cooling scarf" intervention was added to the standard of practice, and the study is continuing with a larger sample. Lessons Learned: A simple request to develop an evidence-based standard of practice evolved into a five-year project. However, the AIDS fever project resulted in staff nurses' interest in using research to determine "best practice" in nursing.en_GB
dc.date.available2011-10-27T11:13:59Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:13:59Z-
dc.conference.date2001en_US
dc.conference.nameENRS 13th Annual Scientific Sessionsen_US
dc.conference.hostEastern Nursing Research Societyen_US
dc.conference.locationAtlantic City, New Jersey, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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