Fever, in the presence of traumatic brain injury (TBI), is associated with worsened neurologic outcomes. Studies prior to the publication of management guidelines revealed an undertreatment of fever in patients with neurologic insults. Presently the adult TBI guidelines state that maintenance of normothermia should be a standard of care therefore improvement in management of fever in these patients would be expected. The specific aims of the study were to: (1) determine the incidence of fever (T>or=38.5 degrees C) in a population of critically ill patients with TBI; (2) describe what interventions were recorded by intensive care unit (ICU) nurses in managing fever; (3) ascertain the rate of adherence with published normothermia guidelines. Medical record review of available hospital records was conducted on patients admitted to a level I trauma center following severe TBI (N=108) from the parent study. Temperature data was abstracted and contemporaneous nursing documentation was examined for evidence of intervention for fever and adherence with published standards. Data analyses were performed that included descriptive statistics. Seventy-nine percent of TBI patients (85/108) had at least one recorded fever event while in the ICU. However in only 31% of events did the patient receive any documented intervention by nursing staff for the elevated temperature. The most frequently documented intervention was pharmacologic (358/1166 elevations). Other nursing actions (e.g. use of fan) accounted for a minority (<1%) of nursing interventions documented. Patients were more likely to have a high temperature that exceeded 40 degrees C (13%) than a temperature that was normothermic (5%). There continues to be an under treatment of fever in patients with TBI by critical care nurses despite our knowledge of its negative effects on outcomes. There remains a gap in translation between patient outcomes research and bedside practice that needs to be overcome, thus research efforts need to now focus on understanding nurses' decision-making processes and the best methods of fever reduction in patients with TBI.

Hilaire J Thompson

Catherine J Kirkness

Pamela H Mitchell

Intensive & critical care nursing

重症和重症监护护理的目的是促进专科护士及其专业同事对重症患者的卓越护理；为研究成果、经验和想法的出版、传播和交流提供一个国际和跨学科论坛；发展和提高对良好的重症监护护理实践至关重要的知识、技能、态度和创造性思维。除了原始论文和重要的初步交流外，该杂志还发表评论、更新和专题文章。文章可以涉及实践的任何部分，包括相关的临床、研究、教育、心理和技术方面。

The journal "Intensive and Critical Care Nursing" aims to promote excellence in the care of critically ill patients by specialized nurses and their professional colleagues. It provides an international and interdisciplinary forum for the publication, dissemination, and exchange of research findings, experiences, and ideas. The journal seeks to develop and enhance the knowledge, skills, attitudes, and creative thinking essential for good practice in intensive and critical care nursing. In addition to original research papers and significant preliminary communications, the journal also publishes commentaries, updates, and thematic articles. Articles may address any aspect of practice, including relevant clinical, research, educational, psychological, and technological issues.

《Intensive and Critical Care Nursing》期刊致力于促进专科护士及其同事对重症患者的卓越护理。它为研究成果、经验和想法的出版、传播和交流提供了一个国际和跨学科的论坛。期刊旨在发展和提升对良好重症监护护理实践至关重要的知识、技能、态度和创造性思维。除了原始研究论文和重要的初步交流外，该杂志还刊登评论、更新和专题文章。文章内容可以涵盖实践的各个方面，包括相关的临床、研究、教育、心理和技术领域。

Intensive and Critical Care Nursing

Intensive Crit Care Nurs

Intensive care unit management of fever following traumatic brain injury.

There continues to be an under treatment of fever in patients with TBI by critical care nurses despite knowledge of its negative effects on outcomes, so research efforts need to now focus on understanding nurses' decision-making processes and the best methods of fever reduction.

Category	Quartile
医学	2
医学, 护理	1

Intensive care unit management of fever following traumatic brain injury.

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