Megan Lammers

Article Critique
I recommend that the policy stating all temperatures must be taken rectally for infants birth to 24
months of age should be changed and the type of temperature measurement should be decided on
upon the situation. This journal article is from 2012 by the Journal of Pediatric Nursing. Jessica
Bahorski, Terri Repasky, Donna Ranner, Ally Fields, Michelle Jackson, Lucy Moultry, Karen
Pierce, Mary Sandell all Registered Nurses came together to write this article. This article on
Temperature Measurement in Pediatrics: A Comparison of the Rectal Method Versus the
Temporal Artery Method was peer reviewed. The background and literature did support a need
for this study because of the low levels of evidence, some of the references were out of date, and
there are many debates on which is the best way to obtain an infants temperature. Studies have
shown that while rectal temperature is often more accurate it can be very invasive for the
pediatric patients; while others have shown temporal temperatures can fluctuate often. The
problem investigated in the article is the differences in temperature readings of infants with two
types of readings, both rectal and temporal. As stated on pg 246 of the article The purpose of
this study was to determine if there is a difference between temperature readings in a group of
pediatric patients when using the temporal method (TAT) versus the rectal method (RT). The
temperatures were obtained using electronic devices. The study had a population of 47, 25 were
female and 20 were male. Two patients were not specified for age. The ages of the participants
ranged from 3-36 months. Thirty-three participants were from the emergency center, 7 from the
pediatric ICU, and 7 from the pediatric outpatient unit. The design of this study consisted of a
comparative, single-group design, this study according to QSEN levels of evidence falls low on
the level of evidences. This is a low level of evidence because it falls in between case control
studies and case reports, it took a report on individual patients and it compared a febrile and
febrile groups as well. The statistical analysis used in this article was discussed on pg 245 where
it stated the data was analyzed using Levene's test for equal variances, which revealed that the
variances were not equal. Also the t test for equality of means was run of the data. In addition,
Pearson's r and Spearman's rho were both used to consider relationship between the two readings
and a febrile and febrile measurements. For this study the level of measure and the statistical
analysis do match the nominal measure of data presented in the two figures showed no
significance with TAT and RT temps the same that was presented in the statistical analysis. The
data analysis results presented in the article revealed no statistically significant differences
between TAT and RT. The results were presented in two figures and were recorded according to
a febrile and febrile. Results were clearly stated however there were some threats to internal
validity present, such as selection bias. Nurses just approached parent or guardians, and asked to
sign consent. Also maturation I believe in this case is a threat to validity because this study is
done on infants 3 months to 36 months when children grow the most. Also the population was
selected from mnay different areas such as the ER or PICU. The results do answer the question
identified, there is no significance difference in TAT and RT. The results do not seem valid due
to the threats to validity identified, the small sample size of only 47 infants, and the different
population areas. The conclusions of the results are not consistent with the few literature reviews
discussed in the article. Some studies showed a positive correlation and other studies showed no
significant correlation between TAT an RT. The results mean a red flag in my eyes to medicine
and health care involving my patients. With studies showing there are no significant difference in
TAT and RT but at the same time showing that RT are invasive and temporal temps are not
accurate this shows that more research needs to be done. The results of this study can be applied
in some ways to my clinical practice in that as a pediatric nurse the goal is to obtain the most
accurate temperature measurement in the least invasive manner. As a nurse we need to consider
all factors when choosing a method to measure temperature. With the results I do believe that
TAT measurement cannot replace RT measurement in all situations, but it could be used for
pediatric patients over the age of 3 months who show no clinical signs of fever.

References
Bahorski, J., Repasky, T., Ranner, D., Fields, A., Jackson, M., Moultry, L., Pierce, K., et al.
(2012). Temperature measurement in pediatrics: a comparison of the rectal method versus the
temporal artery method. Journal of pediatric nursing, 27(3), 243
247. doi:10.1016/j.pedn.2010.12.015
Drenkard, K. (2013). Level of Evidence Review. In American Association of Colleges for
Nursing QSEN . Retrieved July 13, 2014, from http://www.aacn.nche.edu/qsen/workshop-
details/new-orleans/KD-EBP.pdf
Nieswiadomy, R. (2012). Foundations of Nursing Research (6thth ed., pp. 114-117). Upper
Saddle River, NJ: Pearson Education.