Authors (including presenting author) :
KWOK C.Y., HO Y.M., TAM P.Y., TSE W.K., YUEN K.M., WONG W.H., TSE C.H.
Affiliation :
Department of Paediatrics and Adolescent Medicine, Caritas Medical Centre
Introduction :
Febrile illness was the most common clinical conditions that paediatric healthcare team had to manage every day. Caregivers also had their own practices to handle children’s fever at home and even during hospitalization. However, the fever management information that caregivers received might not be evidence-based. Those myths and inappropriate practices were not beneficial in fever reduction, but could be fatal to paediatric patients.
Objectives :
(1) To examine the current available literatures so as to identify the best practices in managing febrile children
(2) To provide evidence-based information to enhance frontline paediatric staff including nurses, PCAs and caregivers’ knowledge and confidence levels in managing febrile children
(3) To standardize the safe practice of frontline staff
Methodology :
(1) A literature review aimed to examine the current available literatures in managing febrile paediatric patients was conducted. Databases including Cochrane Library, JBI EBP Database, CINAHL, MEDLINE, EMBASE were searched for Meta-analysis, systematic review, randomized controlled trial, any experiment design studies, observational studies or evidence-based practice guidelines in English in recent 15 years. The level and quality of the literature was critically appraised by JHNEBP Research and Non-research Evidence Appraisal Tool. Nine literatures were included in the review with one in high quality and eight of them in good quality.
(2) An evidence-based practice (EBP) project was conducted in ward by employing Johns Hopkins Nursing Evidence-Based Practice Model (2017) from December 2018 to December 2019. This EBP project including (2a) an education programme with pretest and posttest survey was conducted for staff; (2b) evidence-based educational materials such as educational video and quick reference cards were produced for caregivers; and (2c) clinical practices were advanced and standardized by employing updated evidences such as ice pack or tepid sponging are no longer recommended and routinely offered for fever reduction.
Result & Outcome :
(1) 95% of nurses participated in the education programme strongly agreed and agreed that the programme enhanced their knowledge and confidence and was useful to their work. (2) Increased knowledge and confidence level were reported from caregivers after receiving our evidence-based educational materials. (3) More than 90% nurses’ and PCAs’ compliance on new practices by spot-checking and observing their daily practice in July and August 2019. This evidence-based practice (EBP) project was effective to enhance nurses, PCAs and caregivers’ knowledge and confidence levels in managing febrile children. The clinical practice and safety in managing febrile paediatric patient were advanced and standardized.
