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Effect of hot or cold beverages on baseline temperature

According to recent research by nurses at the University of Virginia Health System, your mother was right when she told you not to eat or drink anything before taking your temperature. On average, study participants consuming cold beverages required 15 minutes for their temperature to return to baseline, while those consuming hot beverages returned to baseline after 23 minutes.

“It’s something that comes up in our practice on a regular basis,” said Tricia Jenkins, RN, BSN, a member of the research team. “Nurses take temperatures several times a day, every day, so the research was really applicable.”

The study was the first to examine effects of beverage consumption on accuracy of oral electronic thermometers. Previous research on the topic used only men as research subjects and tested oral temperature with mercury-filled thermometers.

“Since many patients’ vital signs are assessed near a meal time, our findings can now serve as a guideline to check temperature before food or beverages are consumed, or wait approximately 15-25 minutes for temperatures to return to baseline,” said Beth Quatrara, RN, MSN, APRN-BC, research project coordinator. “It’s always best to provide patient care based on evidence rather than guessing at it.”

The nurses’ findings were presented at the Academy of Medical-Surgical Nurses convention in October.

Nursing home care by RNs associated with better outcomes
When registered nurses provide 30 to 40 minutes of direct care each day for nursing home residents, better health outcomes are achieved, according to a study published in the November issue of American Journal of Nursing. The association between more time spent in direct care and better outcomes was much stronger for registered nurses than for licensed practical nurses and certified nursing aids.

The study focused on the impact of nurse staffing time on prevention of pressure ulcers (bedsores).

“While the study examined other adverse outcomes, pressure ulcers are one of the most common and costly problems in nursing homes today,” said Susan D. Horn, PhD, co-author of the study. Horn is senior scientist at the Institute for Clinical Outcomes Research and vice president of research for International Severity Information Systems in Salt Lake City, Utah.

Bedsores are associated with higher rates of morbidity and mortality and poorer quality of life, yet many nursing homes fail to provide a plan of care or basic preventive measures that target pressure ulcers within 48 hours of admission. Increasing the proportion of RNs in nursing homes to improve the quality of care will require significant financial commitment from Medicaid and other health insurers.

Keeping older RNs in work force
Older nurses are working less in acute care settings as they get older, choosing instead employment in areas not as physically demanding. In a study presented in the November/December 2005 issue of Nursing Economic$, Linda D. Norman, RN, DSN, FAAN, and co-authors advise health care leaders and policy-makers to make bold efforts to retain new and older nurses in all settings to avoid future shortages.

Norman and co-authors believe nursing shortages will likely occur in specialty hospitals, sub-acute and long-term care facilities, and home or community care organizations as older nurses working in those settings begin to retire. At the same time, younger nurses employed in acute care settings will likely be recruited to replace the retiring nurses, creating a greater shortage of nurses in acute care settings than what already exists.

The authors recommend health care employers consider tactics proposed by a recent report of a global summit on the aging work force. Such tactics include investing in health promotion activities for workers, retraining employees as they age and conducting research to determine what conditions contribute best to healthy aging. Salary increases and other economic incentives that acknowledge the skills, experience and value of older nurses also should be considered, according to the authors.

In the study, nurses noted decreased physical stamina and strength as reasons for leaving the hospital work force. Norman and co-authors suggest employers lessen physical demands for older nurses and offer exercise training and other health promotion activities to all nurses to help retain older nurses in hospital settings. RNL

Reference

Norman, L., Donelan, K., Buerhaus, P., Willis, G., Williams, M., Ulrich, B.T., & Dittus, R. (2005). The older nurse in the workplace: Does age matter?, Nursing Economic$, November/December.