{"title":"[Detection of Fever Using Continuous Skin Temperature Monitoring in Hospitalized Older Adults].","authors":"Yi-Jhen Chen, Yi-Ting Chung, Chang-Chun Chen, Yen-Chin Chen, Shih-Hsin Liang, Jiun-Ling Wang, Chun-Yin Yeh, Kun-Ta Chuang, Nai-Ying Ko","doi":"10.6224/JN.202302_70(1).09","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The continuous monitoring of body surface temperature has been proven to help detect potential fever events in hospitalized patients. However, the efficacy of using body surface temperature to detect fever in older adults remains unclear due to the relatively low and slower-to-change body surface temperature in this population.</p><p><strong>Purpose: </strong>This study was designed to investigate 1) the relationship between changes in body surface and routine tympanic temperatures, 2) the correlation between body surface temperature measurement frequency and detection of fever, and 3) the factors related to the incidence of fever in hospitalized older adults.</p><p><strong>Methods: </strong>A prospective study was conducted on 33 hospitalized older adults aged 65 years or older who were suspected to have or diagnosed with an infection in an infectious disease and medical ward at a medical center in southern Taiwan from March to November 2020. Demographic, routine tympanic temperature, and heart rate data were collected by reviewing the participants' medical records. Body surface temperatures were monitored continuously using HEARThermo every 10 seconds until one of the following conditions were met: hospital discharge, no fever for three continuous days, and HEARThermo was removed. Descriptive analysis was used to compare the variations in body surface temperature and routine tympanic temperature measurements. Pearson correlation was used to analyze the correlation between different measurement frequencies and fever events. Finally, mixed effects logistic regression was used to analyze the factors significantly related to fever events.</p><p><strong>Results: </strong>Seven hundred and twenty routine body temperature measurements were taken, with 209 (29.0%) fever events detected in 23 (69.7%) of the participants. The body surface temperatures were more closely correlated with tympanic temperatures during fever events than non-fever events (r = .260, p < .001). More fever events were detected using body surface temperature monitoring frequencies of every 10 seconds and every 1 minute. After controlling for demographic factors, the results of the mixed effect model indicate that body surface temperature and heart rate are significant factors related to fever events in hospitalized older adults (odds ratio, OR: 1.74, p < .001; OR: 1.11, p < .001).</p><p><strong>Conclusions / implications for practice: </strong>The continuous monitoring of body surface temperature may improve the detection of fever events in hospitalized older adults. The application of wearable devices and cloud platforms may further facilitate the real-time assessment and care capabilities of nurses, thus reducing their workload and improving care quality.</p>","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Nursing","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.6224/JN.202302_70(1).09","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Nursing","Score":null,"Total":0}
引用次数: 0
Abstract
Background: The continuous monitoring of body surface temperature has been proven to help detect potential fever events in hospitalized patients. However, the efficacy of using body surface temperature to detect fever in older adults remains unclear due to the relatively low and slower-to-change body surface temperature in this population.
Purpose: This study was designed to investigate 1) the relationship between changes in body surface and routine tympanic temperatures, 2) the correlation between body surface temperature measurement frequency and detection of fever, and 3) the factors related to the incidence of fever in hospitalized older adults.
Methods: A prospective study was conducted on 33 hospitalized older adults aged 65 years or older who were suspected to have or diagnosed with an infection in an infectious disease and medical ward at a medical center in southern Taiwan from March to November 2020. Demographic, routine tympanic temperature, and heart rate data were collected by reviewing the participants' medical records. Body surface temperatures were monitored continuously using HEARThermo every 10 seconds until one of the following conditions were met: hospital discharge, no fever for three continuous days, and HEARThermo was removed. Descriptive analysis was used to compare the variations in body surface temperature and routine tympanic temperature measurements. Pearson correlation was used to analyze the correlation between different measurement frequencies and fever events. Finally, mixed effects logistic regression was used to analyze the factors significantly related to fever events.
Results: Seven hundred and twenty routine body temperature measurements were taken, with 209 (29.0%) fever events detected in 23 (69.7%) of the participants. The body surface temperatures were more closely correlated with tympanic temperatures during fever events than non-fever events (r = .260, p < .001). More fever events were detected using body surface temperature monitoring frequencies of every 10 seconds and every 1 minute. After controlling for demographic factors, the results of the mixed effect model indicate that body surface temperature and heart rate are significant factors related to fever events in hospitalized older adults (odds ratio, OR: 1.74, p < .001; OR: 1.11, p < .001).
Conclusions / implications for practice: The continuous monitoring of body surface temperature may improve the detection of fever events in hospitalized older adults. The application of wearable devices and cloud platforms may further facilitate the real-time assessment and care capabilities of nurses, thus reducing their workload and improving care quality.
背景:连续监测体表温度已被证明有助于发现住院患者潜在的发热事件。然而,由于老年人体表温度相对较低且变化较慢,因此使用体表温度检测老年人发烧的有效性尚不清楚。目的:探讨住院老年人体表变化与常规鼓室温度的关系,体表温度测量频率与发热检出率的相关性,以及与发热发生率相关的因素。方法:对2020年3月至11月在台湾南部某医疗中心传染病病房疑似感染或确诊感染的33名65岁及以上住院老年人进行前瞻性研究。通过回顾参与者的医疗记录收集人口统计、常规鼓室温度和心率数据。每10秒使用HEARThermo连续监测体表温度,直到满足以下条件之一:出院,连续三天不发烧,取出HEARThermo。描述性分析用于比较体表温度和常规鼓室温度测量的变化。采用Pearson相关分析不同测量频率与发热事件的相关性。最后,采用混合效应logistic回归分析与发热事件显著相关的因素。结果:共进行720次常规体温测量,其中23例(69.7%)发热209例(29.0%)。发热时体表温度与鼓室温度的相关性高于非发热时(r = 0.260, p < 0.001)。使用每10秒和每1分钟的体表温度监测频率检测到更多发热事件。在控制人口统计学因素后,混合效应模型结果显示,体表温度和心率是住院老年人发热事件的显著相关因素(优势比OR: 1.74, p < 0.001;OR: 1.11, p < 0.001)。结论/实践意义:持续监测体表温度可以提高住院老年人发热事件的检测。可穿戴设备和云平台的应用可以进一步促进护士的实时评估和护理能力,从而减少护士的工作量,提高护理质量。