Purpose: A systematic review of literature and intensive evaluation were conducted using a quality process to assess temporal artery thermometer (TAT) accuracy in an acute-care setting.
Background: Inaccurate temperature measurements were reported following adoption of the TAT. Concern for patient safety and outcomes generated a need to reevaluate use of the TAT.
Description of the project: Using components of evidence-based practice and intensive evaluation processes, a clinical nurse specialist (CNS)-led team evaluated existing research, assessed current practice, and obtained additional clinical data.
Outcomes: Existing research provides inadequate evidence to support use of the TAT for acutely ill hospitalized patients. Findings from an intensive evaluation indicated low interrater reliability in controlled testing, inaccurate technique by staff despite retraining, lack of nurse confidence in the accuracy of the device, and a need for continuous costly retraining. These findings are consistent with findings in a University HealthSystem Consortium report.
Summary and conclusions: A multifaceted evaluation process was needed for the team to compile data, identify issues, and make decisions. A recommendation was made to discontinue use of the TAT.
Implications: : Clinical nurse specialists have the knowledge and ability to provide clinical leadership at a system level. When usual processes result in safety concerns, the CNS provides leadership to identify patterns, provide direction, creatively integrate evaluation processes, synthesize findings, and uses his/her influence within the system to change practice.