I recommend that the temperatures of infants from birth to 24 months of age should be

taken rectally and that no policy change should be made based on the article by Bahorski et al.
(2012). The article was from the Journal of Pediatric Nursing, a peer-reviewed, nursing journal
(http://www.pediatricnursing.org/home). The authors of this article included seven registered
nurses and one certified child life specialist; all of the authors are based in a hospital in
Tallahassee, Florida. The main subject of the study was taking temperatures in pediatric
patients. The background and the literature review supported a need for this study. The
currently preferred method of using a rectal thermometer (RT) has several pitfalls. The temporal
artery thermometer (TAT) has mixed reviews on the accuracy and the clinical significance of the
method. There are conflicting viewpoints from studies and from a professional organizations
recommended method of taking temperature. The literature review had low level evidence,
levels C and D (Armola et al., 2009). This study looked at the accuracy of different types of
thermometers in pediatrics. The purpose of this article was to see if there was a significant
difference in TAT versus RT temperature readings in patients between 3 and 36 months of age.
The sample population for this study was patients between 3 and 36 months of age who were in
three departments of a large hospital. A comparative, single-group design was the design of this
study. This method was appropriate because the same patient was used to determine if there was
a difference in the temperatures read by the two instruments. This study has a level B rating
according to the AACN level of evidence ranking system. The t-test is used for statistical
analysis and this is appropriate considering the data is interval data. The results indicate that
there is no significant difference between TAT and RT methods. The results are clear, yet the
authors voice some doubt over the clinical significance of missing a fever using the TAT
method based on the literature review. The results answer the question of the accuracy of the
TAT versus the RT, showing that they are comparable. There were a few validity issues that
arose. Firstly, instrumentation is an issue because the thermometers were initially calibrated, but
no additional checks were done to ensure they were in proper working order throughout the
study. Secondly, maturation is a threat to validity because the patients temperature could have
gone up or down. The RT was taken immediately after the TAT, but immediately could mean
different things to the nurses who were testing, no time frame was specified. The conclusions of
this study are similar to other studies that have been performed. They indicate that there is no
statistical difference in measurement. The results indicate that if TAT is to become the primary
temperature method for pediatrics, the instruments need to become more sensitive to mild
changes. This leaves room for improvement in the design of the instrument. These results could
indicate a noninvasive way to test temperature that patients would prefer. This study indicated
that TAT should be used on patients who are not at risk for a fever; this could be a future area of
study. Additional research needs to be performed to determine when it would be appropriate to
use the TAT. Practice change would not be indicated due to this article alone. An additional
thought is that the current policy is for newborns to patients 24 months old, and this study does
not look at patients from the age of newborn to 3 months old. There is no information that would
support a change for this age group. The TATs were donated by a corporation, so the study
could have been influenced by that factor. No policy change is recommended.


Works Cited
Armola, R. R., Bourgault, A. M., Halm, M. A., Board, R. M., Bucher, L., Harrington, L., &
Heafey, C. A. (2009, August). AACN levels of evidence: What's new? Critical Care
Nurse, 29(4), 72. doi:10.4037/ccn2009969
Bahorski, J., Repasky, T., Ranner, D., Fields, A., Jackson, M., Moultry, L., & Pierce, K. (2012).
Temperature measurement in pediatrics: A comparison of the rectal method versus the
temporal artery method. Journal of Pediatric Nursing, 27, 243-247. Retrieved July 14,
2014, from http://www.pediatricnursing.org/