Nurse Practitioners' Treatment of Febrile Infants in Utah: Comparison to Physician Practice Nationally

Authors


Contact Dr.Lookinland by E-mail: sandra_lookinland@byu.edu.

Abstract

Purpose

To determine nurse practitioners' (NPs') knowledge of published guidelines involving the treatment of infants with fever without a source and to compare the practice of NPs in Utah to physicians nationally.

Data Sources

Using a comparative descriptive design, a survey was sent to 450 NPs in Utah replicating the methodology of a 1998 survey of physicians. The NPs were asked about their evaluation decisions and management strategies for various ages of infants/toddlers with fever without a source.

Conclusions

The practice decisions of NPs in Utah and physicians nationally were similar. Family NPs' clinical decisions aligned more closely with family practice medical doctors and pediatric NPs' with pediatricians. Overall, the younger the patient, the more likely were NPs to order labs and antibiotics or to hospitalize/refer to a physician. The fact that management decisions were not based upon existing protocols may account for the practice variation seen among NPs.

Implications for Practice

Management of a febrile infant is a common clinical scenario for the primary care provider. Although evidence-based protocols exist, the treatment of febrile infants remains controversial. Overall, NPs' evaluation and management of these infants were not shown to differ from physicians. Further studies are needed to determine why clinical guidelines are not being followed.

Ancillary