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American Journal of Critical Care. 2008;17: 522-531
Copyright © 2008 by the American Association of Critical-Care Nurses.
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Nursing Workload Associated With Fever in the General Intensive Care Unit

By Panagiotis Kiekkas, RN, MSc, PhD, George C. Sakellaropoulos, PhD, Hero Brokalaki, RN, PhD, Evangelos Manolis, MD, PhD, Adamantios Samios, RN, Chrisula Skartsani, RN and George I. Baltopoulos, MD, PhD. Panagiotis Kiekkas is a grade B nurse in the anesthesiology department, and Adamantios Samios and Chrisula Skartsani are grade A nurses in the intensive care unit at Patras University Hospital, Patras, Greece. George C. Sakellaropoulos is an assistant professor in the Department of Medical Physics, University of Patras, Greece. Hero Brokalaki is an assistant professor, Evangelos Manolis is an associate professor, and George I. Baltopoulos is a professor in the School of Nursing, University of Athens, Greece.

Corresponding author: Panagiotis Kiekkas, 76 Stratigou Konstantinopoulou St., Aroi, Patras 263-31, Greece (e-mail: kiekkpan{at}otenet.gr).

Background Fever in a patient in the intensive care unit necessitates several nursing tasks. Moreover, factors associated with increased patient care needs may be associated with fever.

Objective To identify relationships between fever and characteristics of fever and nursing workload at the patient level.

Methods A prospective study was conducted in a medical-surgical intensive care unit. The sample consisted of 361 patients consecutively admitted from October 2005 to August 2006. Each patient’s body temperature was measured by using a tympanic membrane or an axillary thermometer. The Therapeutic Intervention Scoring System-28 was used to measure nursing workload.

Results A total of 188 patients (52.1%) had fever. Mean daily scores on the Therapeutic Intervention Scoring System and on 5 of its 7 categories were significantly higher for febrile patients than for nonfebrile patients. Fever was an independent predictor of the mean daily scores for all patients (P < .001). Peak body temperature but not duration of fever also was an independent predictor of mean daily scores for febrile patients (P < .001).

Conclusion In a general intensive care unit, fever in patients should be taken into consideration for the proper allocation of nursing personnel.




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