Date of Award

Spring 5-23-2015

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Susan Instone, DNSc, RN, CPNP, Faculty Chairperson

Second Advisor

Mary Jo Clark, PhD, RN, Seminar Faculty

Abstract

Fever phobia is persistent in the pediatric population, as fever is a common complaint for advice calls, sick visits, and urgent care/emergency department utilization. Fever phobia among parents and healthcare providers is evidenced by the quest to return a child to normothermia. Fevers under 38.5ºC (101.3ºF) are considered benign in healthy children, usually requiring no pharmaceutical intervention. Research consistently demonstrates pediatric nurses inappropriately medicate patients for low-grade fevers. The purpose of this evidence-based practice project was to identify knowledge of the benefits and myths of fever in otherwise healthy children and to decrease the use of antipyretics for low-grade fevers among pediatric emergency nurses.

Testing was conducted before and after a didactic presentation on the pathophysiology, benefits, and myths regarding fever. A 3-month follow-up test evaluated retained knowledge. Antipyretic administration rates were compared for three months prior to and after the intervention to evaluate reduction in administration at triage for fevers under 38.5ºC (101.3ºF).

Knowledge increased by only 8% after intervention and was retained at 3-month testing. A decrease in rate of administration was found, but cannot be attributed solely to this intervention.

Given the persistent lack of knowledge and tendency to over-treat low-grade fevers in children by pediatric emergency nurses, fever phobia persists and continues to lead to the misuse of resources. Presenting nurses with additional education and resources to strengthen knowledge of fever and dispel myths may help bring about needed change. Future qualitative research may reveal barriers and facilitators for making this change in nursing practice.

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