Fever Management: Paediatric Nurses' Knowledge, Attitudes and Influencing Factors

ABSTRACT Background Despite evidence-based support for the beneficial effects of fever over the past three decades health professionals’ negative attitudes toward fever and reliance on antipyretics to reduce fever have persisted and continue to be reported in the literature. Aims This paper describes Australian paediatric nurses’ knowledge of and attitudes toward fever and fever management and the predictors of their intentions to administer paracetamol to a febrile child. Methods A self-report questionnaire identified knowledge, attitudes and factors influencing nurses’ intention to administer paracetamol to febrile children. Fifty-one paediatric nurses working in medical wards of a metropolitan paediatric hospital in Australia participated. An instrument was developed, piloted by test re-test and revised prior to data collection. Results Nurses’ mean knowledge about the physiology of fever, general fever management and antipyretics was 62%, not as high as expected. Participants reported positive attitudes toward the benefits of fever, the necessity for fever reduction in children with pre-existing cardiac or respiratory conditions and regular antipyretic administration masking the infective process. Negative attitudes included disbelief that temperature is often unrelated to illness severity. Conflicting attitudes toward febrile convulsions were highlighted by beliefs that antipyretic therapy prevents febrile convulsions and that antipyretics do not prevent initial febrile convulsions. Predictors of intentions to administer paracetamol were beliefs about the effectiveness of paracetamol and normative beliefs. Nurses reported strong intentions to administer paracetamol to the next febrile child they cared for. However, the use of a nurse manager for recruitment might have influenced socially desirable responses and undertaking the study at one site limits the generalisability of findings. Conclusions Fever management is an integral aspect of paediatric nursing. For consistent rational fever management nurses’ knowledge must improve, their positive attitudes enhanced and negative attitudes challenged. This highlights the need for continuing education in fever management