الفهرس 
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Abstract
Fever is a common childhood problem faced by health care personnel including
doctors, nurses and others in both hospitals and community settings. Lack of knowledge and presence of conflicting information regarding management of children having fever influences the quality of care and children’s health. Conflicting knowledge related to the
management of febrile illness continue to be of the most prevalent childhood health issues encountered by nurses. Pediatric nurses with a comprehensive understanding and knowledge of fever management practices will be able to educate parents about care of febrile children and contribute to the improvement of children’s health status.
The purpose of the study was to: -
1. Assess the effect of an evidence-based protocol for childhood fever management on quality of care provided by nurses. Research design: -
A quasi-experimental research design was used to assess the effect of an evidence- based protocol for childhood fever management on quality of care provided by nurses. Setting: - This study was conducted at pediatric medical department and pediatric intensive care unit in Menoufia University Hospital.
Sampling: - All nurses providing care for children in Pediatric Medical Department and Pediatric Intensive Care Unit were included in this study (48 nurses). The number of studied nurses at Pediatric Medical Department and Pediatric Intensive Care Unit in
Menoufia University Hospital was 18 and 30 respectively. Instruments of the study: - Two instruments were utilized for data collection: Instrument one: Structured Interviewing Questionnaire:
It was a structured interviewing questionnaire. It was developed by the researcher guided by Walsh et al. (2005) after reviewing related literature. It was divided into three parts: Part one: Social characteristics of studied nurses. Part two: Nurses’ knowledge about fever. Part three: Nurses’ knowledge about nursing care related to fever. Instrument two: Nurses’ Clinical Performance Observational Checklist:
It was developed by researcher guided by Bowden and Greenberg (2012) after
reviewing related literature to observe nursing management of fever. It was divided into three parts: Part one: Immediate assessment on admission.
Part two: Management of child with fever. Part three: Documentation and advice for home carea The main results of the study showed that: More than half of studied nurses (58.3%) aged between 20-<30 years with mean age 25.1 ± 2.3 years.. Less than half of studied nurses (45.8%) had nursing diploma. The majority of studied nurses (79.2%) did not attend any training courses on caring of children with fever.
4. Less than half of studied nurses (41.6%) had more than 10 years of experiences. The mean score of nurses’ knowledge on pretest were 43.8± 10.1 compared to 77.3±3.6 and 75.5±4.1 on post and follow-up tests. All nurses had more satisfactory knowledge on posttest compared to pretest(100% Vs 35.4% respectively).. Nurses had the highest mean total scores of practice (immediate assessment on admission, management of child with fever and documentation and advice for home care) on posttest (8.3±1.1 Vs 18.5±1.6, 0.81±0.3 Vs 18.5±1.1 and 2.0±0.0 Vs 8.3±0.5).
8. Nurses had higher mean total score of practices on posttest compared to pretest (45.1± 2.1 Vs 11.1± 1.3 respectively).. There was a very highly statistically significant positive correlation between total knowledge and total practices at 0.0001% level of statisticasignificance(r=0.927).The study concluded that: The current study concluded that nurses who participated in evidence-based protocol had higher level of evidence-based knowledge related to fever management on
posttest than pretest. Quality of care provided by nurses for children having fever was higher after implementation of the evidence- based protocol (posttest) than on pretest. Based on the results of the study, it was recommended that:
1. Ongoing in-service education programs about evidence- based childhood fever
management should be designed and implemented in pediatrics departments and pediatric intensive care units to improve pediatric nurses’ knowledge and
practices. Standardized evidence- based protocols for childhood fever should be integrated into pediatric nursing curriculum. Different methods of teaching such as group discussion, presentations, demonstration, redemonstration and explanatory booklets must be used.. Libraries containing books, electronic media and internet access for all medical and nursing staff should be established at hospitals settings and should contain evidence-based guidelines regarding childhood fever. Hospitals administrative authorities should develop policies encourage the utilization of lukewarm water (36.66oC- 40.55oC or 98 oF -105 oF) for the management of fever rather than other methods such as rubbing with alcohol and utilization of tape water
Future studies should be applied on a larger sample of nurses in other pediatric medical departments to investigate the effect of evidence-based protocol for childhood fever management on quality of care provided by nurses to ensure the generalizability of results.