Improving Pediatric Temperature Measurement in the ED.

OVERVIEW: ED care providers have long debated which of the various methods of temperature measurement of pediatric patients is best. While the efficacy and accuracy of temporal artery, tympanic membrane, axillary, and infrared temperature measurement have been studied, the gold standard has been rectal temperature measurement. But despite its accuracy, this method causes children with noninfectious complaints and their families unnecessary distress and adds significant time to the triage process. In response, a group of ED staff nurses at a multihospital health system conducted an evidence-based quality improvement project to determine the best practice for accurate temperature measurement in children younger than five years who presented to the ED. The project included an exhaustive literature search, a review of relevant studies, the development of a table of evidence, a presentation of the findings, and recommendations for practice change. This article describes the project and the adoption of temporal artery thermometry, a painless, noninvasive screening method that provided consistently accurate temperature measurement as well as increased patient and nurse satisfaction and a shorter triage process.