Knowledge and Performance of Guidelines for Evaluation of New Fever in Critically Ill Adult Patients

중환자 첫 발열 평가 근거기반 가이드라인에 대한 지식과 수행 정도

  • 양진주 (광주보건대학교 간호학과) ;
  • 장금성 (전남대학교 간호대학) ;
  • 최자윤 (전남대학교 간호대학) ;
  • 류세앙 (국립목포대학교 간호학과) ;
  • 김윤희 (국립목포대학교 간호학과)
  • Received : 2016.07.08
  • Accepted : 2016.10.26
  • Published : 2016.12.28


The purpose of this study was to investigate nurses' knowledge and performance of guidelines for evaluation of new fever in critically ill adult patients according to the level of evidence. The total participants were 145 nurses working for medical surgical unit and intensive care unit in two hospitals. The knowledge and performance mean scores of guidelines were $0.70{\pm}0.09$ and $3.08{\pm}0.31$ respectively. The evidence level 1 of guidelines had the higher performance score in high score group than low score group of knowledge groups(F=3.86, p=.023) and performance groups(F=163.14, p<.001), while the evidence level 3 of guidelines had the higher performance score in low score group than high score group of knowledge groups(F=5.99, p=.003). Knowledge and performance scores were significantly correlated (r=.25, p=.003). In Conclusion, these findings emphasize that clinical professions need to enhance both of knowledge and practice with evidence based guideline of new fever in critically ill patient.


Supported by : 광주보건대학교


  2. K. B. Laupland, R. Shahpori, A. W. Kirkpatrick, T. Ross, D. B. Gregson, and H. T. Stelfox, "Occurrence and outcome of fever in critically ill adults," Critical Care Medicine, Vol.36, No.5, pp.1531-1535, 2008.
  3. P. R. Russo, M. Landon, J. F. Burkard, C. T. Andicochea, and M. Hannon, "Fever evaluation cost and time to treatment in the general surgery patient can be reduced by using a fever practice guideline," Military Medicine, Vol.179, No.10, pp.1166-1170, 2014.
  4. L. H. McIlvoy, "The effect of hypothermia and hyperthermia on acute brain injury," The American Association of Critical-Care Nurses Advanced Critical Care, Vol.16, No.4, pp.488-500, 2005.
  5. H. Vermeulen, M. N. Storm-Versloot, A. Goossens, P. Speelman, and D. A. Legemate, "Diagnostic accuracy of routine postoperative body temperature measurements," Clinical Infectious Diseases, Vol.40, No.10, pp.1404-1410, 2005.
  6. K. B. Laupland and B. Kevin, "Fever in the critically ill medical patient," Critical Care Medicine, Vol.37, No.7, pp.273-278, 2009.
  7. H. 1. Rockett, H. J. Thompson, and P. A. Blissitt, "Fever management practices of neuroscience nurses: What has changed?," The Journal of Neuroscience Nursing, Vol.47, No.2, pp.66-75, 2015.
  8. H. J. Thompson, C. J. Kirkness, P. H. Mitchell, and D. J. Webb, "Fever management practices of neuroscience nurses: National and regional perspectives," The Journal of Neuroscience Nursing, Vol.39, No.3, pp.151-162, 2007.
  9. N. P. O'Grady, P. S. Barie, J. G. Bartlett, T. Bleck, K. Carroll, A. C. Kalil, P. Linden, D. G. Maki, D. Nierman, W. Pasculle, and H. Masur, "Guidelines for evaluation of new fever in critically ill adult patients: 2008 update from the American College of Critical Care Medicine and the Infectious Diseases Society of America," Critical Care Medicine, Vol.36, No.4, pp.1330-1349, 2008.
  10. J. A. Claridge, J. F. Golob, W. Leukhardt M. J. Sando, A. M. Fadlalla, J. R. Peerless, and C. J. Yowler, "The "fever workup" and respiratory culture practice in critically ill trauma patients," Journal of Critical Care, Vol.25, No.3, pp.493-500, 2005.
  11. J. F. Jr. Golob, J. Claridge, M. Sando, W. R. Phipps, C. J. Yowler, A. M. Fadlalla, and M. A. Malangoni, "Fever and leukocytosis in critically ill trauma patients: It's not the urine," Surgical Infections, Vol.9, No.1, pp.49-56, 2008.
  12. 신용순, 김성렬, 유성희, 김선화, 김정희, 김현정, 나라, 채지선, 이혜진, 안영희, 김경옥, "성인 발열 환자를 위한 근거기반 간호 지침 개발 및 평가," 한국성인간호학회지, 제25권, 제30호, pp.250-262, 2013.
  13. K. P. High, S. F. Bradley, S. Gravenstein, D. R. Mehr, V. J. Quagliarello, C. Richards, and T. T. Yoshikawa, "Clinical practice guideline for the evaluation of fever and infection in older adult residents of long-term care facilities: 2008 update by the Infectious Diseases Society of America," Journal of the American Geriatrics Society, Vol.57, No.3, pp.375-394, 2009.
  14. G. 1. Broessner, R. Beer, P. Lackner, R. Helbok, M. Fischer, B. Pfausler, J. Rhorer, L. Kuppers-Tiedt, D. Schneider, and E. Schmutzhard, "Prophylactic, endovascularly based, long-term normothermia in ICU patients with severe cerebrovascular disease: Bicenter prospective, randomized trial," Stroke, Vol.40, No.12, pp.657-665, 2009.
  15. 정용선, 김진선, "아동발열관리에 대한 인터넷 정보의 평가," 한국콘텐츠학회논문지, 제12권, 제12호, pp.702-713, 2012.
  16. R. I. Henker and K. K. Carlson, "Fever: Applying research to bedside practice," AACN Advanced Critical Care, Vol.18, No.1, pp.76-87, 2007.
  17. H. J. Thompson and S. H Kagan, "Clinical management of fever by nurses: Doing what works," Journal of Advanced Nursing, Vol.67, No.2, pp.359-370, 2010.
  18. 류세앙, 김윤희, 장금성, 정경희, 최자윤, 양진주, 박순주, "정맥관 감염예방 근거기반 가이드라인의 수행수준 별 간호사의 지식 및 수행정도," 성인간호학회지, 제24권, 제5호, pp.546-555, 2012.
  20. 유재용, 오의금, 허혜경, 최모나, "중환자실 간호사의 근거기반 감염관리 지식과 수행 수준 및 영향 요인," 성인간호학회지, 제24권, 제3호, pp.232-243, 2012.
  21. 허현정, 박정하, 김명희, "중환자실 간호사의 유치도뇨관, 중심정맥관 및 인공호흡기 감염관리에 대한 지식과 수행도," 한국산학기술학회논문지, 제17권, 제6호, pp.113-120, 2016.
  22. D. L. Arts, S. Visscher, W. Opstelten, J. C. Korevaar, A. Abu-Hanna, and H. C. van Weert, "Frequency and risk factors for under- and over-treatment in stroke prevention for patients with non-valvular atrial fibrillation in general practice," PLoS One, Vol.8, No.7, e67806, 2013.
  23. A. L. Beukenhorst, D. L. Arts, W. Lucassen, K. J. Jager, and S. N. Van der Veer, "Guideline-related barriers to optimal prescription of oral anticoagulants in primary care," The Netherlands Journal of Medicine, Vol.74, No.4, pp.162-170, 2016.
  24. 박명화, 근거중심 간호의 이해와 적용, 군자출판사, 2006.
  25. D. Fehlings, L. Switzer, B. Findlay, and S. Knights, "Interactive computer play as "motor therapy" for individuals with cerebral palsy," Seminars in Pediatric Neurology, Vol.20, No.2, pp.127-138, 2013.
  26. S. Knights, N. Graham, L. Switzer, H. Hernandez, Z. Ye, B. Findlay, W. Y. Xie, V. Wright, and D. Fehlings, "An innovative cycling exergame to promote cardiovascular fitness in youth with cerebral palsy," Developmental Neurorehabilitation, Vol.19, No.2, pp.135-140, 2016.