| Learning Objective #1: Describe incidence and characteristics of body temperature elevation in HIV/AIDS inpatients. | |||
| Learning Objective #2: Discuss goals of care in acute-care nursing management of HIV-related fever. |
Objective: Although fever is a common symptom in HIV/AIDS, controversy exists as to the best way to manage fever (Holtzclaw, 1995). Nursing studies were conducted to determine the goal of nursing care in management of HIV-related fever in hospitalized patients, and the fever intervention that would best meet this goal. Design: Descriptive exploratory Population, Sample, Setting, Years: HIV/AIDS patients at a South Florida hospital, 1994-1999 Methods: After IRB approval, medical records of 100 HIV+ inpatients were reviewed to determine incidence and characteristics of body temperature elevation. Grossman and Keen’s (1995) Fever Questionnaire was used to determine goals of nursing care and current nursing practice for HIV/AIDS fever management. A qualitative study was conducted to discover patients’ perspective of the HIV fever experience. Study findings were used to design an intervention study. Ten patients, serving as their own control, evaluated three different interventions for fever care: antipyretic administration alone (oral acetaminophen 650 mg) versus antipyretic administration combined with a physical cooling method (cool compresses to the forehead versus a “cooling scarf” to the neck). Findings: Episodes of temperature elevation occurred frequently in this sample. Unlike fever typically seen in medical-surgical patients, episodes were irregular, self-limiting, and not accompanied by an elevated WBC. Patients perceived fever as discomfort and “the hot and cold”. Goals of nursing care were to decrease body temperature while simultaneously increasing patient comfort (Jones, 1998). The intervention of antipyretic administration combined with a “cooling scarf” was the most effective intervention to meet these goals (Jones, 1999). Conclusion: Based on the evidence from study findings for this particular sample, nursing standards of practice at the hospital were revised to reflect study findings. Implications: Further study is recommended to determine whether antipyretic administration plus a “cooling scarf” is an effective fever care intervention for other groups of hospital patients.
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Sigma Theta Tau International
9 July 2003