Improving Triage Times and Patient/Staff Satisfaction using a Temporal Artery

Thermometer in the ED setting.Jennifer Kendrick RN,BSN; Sandra Kueider, MS,RN,NE-BC; Susan Owens,

RN,BSN,CEN

Annie Penn Emergency Department, Cone Health System

• Rectal thermometers are invasive to pediatrics and decrease triage times.

• Standard way of obtaining temperatures on patients under the age of

three was via rectal thermometers.

• Needed to find a method that would ensure nurse, patient, and parent

satisfaction for all of our patients.

• To test effectiveness of temporal artery thermometer (TAT) we first had

to educate staff and present evidence to medical director and ER

physicians to promote physician acceptance.

• To determine if using a temporal artery thermometer on all ED

patients in triage would decrease the overall triage time and improve

patient and staff satisfaction using a less invasive method.

BACKGROUND

PURPOSE

Design:

-retrospective pilot study

-evidence based practice model guided the shared governance

committee in the ED to implement this study

Setting:

-rural hospital, which is part of a not for profit healthcare system,

located in the southeastern United States

-study was conducted in a 23 Emergency Department (ED) that

averages 37,000 patients a year.

Participants/Subjects:

-all patient populations being cared for in the ED were included in this

study

-sample size 102 patients

Methods:

-Every patient that presented to the ED, excluding EMS patients, was

part of this study during the pilot time frame.

-A random sample of triage times was compared to pilot triage times to

determine if times were improved using the TAT.

-The triage nurse completed a TAT evaluation form, using a Likert scale,

to determine ease of use, patients/staff preference, and staff perception related

to triage times.

Temporal Artery Thermometer Evaluation

Average Triage Times in Seconds

MATERIALS AND METHODS

0

0.2

0.4

0.6

0.8

1

1.2

Ease of Use Quicker Patient Preferred Staff Perferred Effective Training TAT decreased

Triage Time

Strongly Agree

Agree

Undecided

Disagree

Stronlgy Disagree

0 50 100 150 200 250 300 350

Using TAT

Traditional Thermometers

Hurwitz, B., Brown, J., & Altmiller, G. (2015). Improving pediatric temperature measurement in the ed. American Journal of Nursing, 115(9), 48-

55. doi: 10.1097/01.NAJ.0000471249.69068.73

Lawson, L., Bridges, E., Ballou, I., Eraker, R., Greco, S., Shively, J., & Sochulak,V. (2007). Accuracy and precision of noninvasive temperature

measurements in adult intensive care patients. American Journal of Critical Care, 16(5), 485-496. Retrieved from

http://ajcc.aacnjournals.org/content/16/5/485.full

Moore, A., Carrigan, J., Solomon, D. Tart, R. (2015). Temporal artery thermometer to detect pediatric fever. Clinical Nursing Research, 24(5), 556-

63 . doi: 10.1177/1054773814557481

Odinaka, K.,Edelu, B., Nwolisa, C., Amamilo, I., & Okolo, S. (2014). Temporal artery thermometer in children younger than 5 years. Pediatric

Emergency Care, 30(12), 867-870.

Penning, C., Van der Linden, J., Tibboel, D., & Evenhuis, H. (2011). Is the temporal artery thermometer a reliable instrument for detecting fever in

children. Journal of Clinical Nursing, 20(11-12), 1632-1639. doi: 10.1111/j.1365-2702.2010.03568.x.

Titus, M., Hulsey, T., Heckman, J., & Losek, J. (2009). Temporal artery thermometer utilization in pediatric emergency care. Clinical Nursing

Research, 48(2), 190-193. doi: 10.11777/0009922808327056

• This study has shown that using the Temporal Artery Thermometer in

triage on emergency department patients has:

• decreased triage times

• ED nurses reported increased satisfaction using the TAT

versus traditional thermometers.

• Patients rated their experience with the TAT favorably and

preferred this method.

-The impact to leadership in conducting this study has shown the

need to continue use of the TAT in triage to decrease triage times

and improve patient/staff satisfaction.

Insert your acknowledgements here. This research supported by…

Outcome:

-results were significant

-retrospective average times were 309 seconds

-during the pilot study, triage times were 240 seconds using the

TAT.

-The data showed a decrease in triage times by 75 seconds per

patient.

-Staff preferred the TAT 100% of the time while the patient

preference was 92% of the time.

-Staff also felt that triage time was decreased by using the TAT.

RESULTS

CONCLUSIONS

REFERENCES