Academic journal article Journal of Nursing Measurement

A Multimethod Approach to Evaluate Chemical Dot Thermometers for Oral Temperature Measurement

Academic journal article Journal of Nursing Measurement

A Multimethod Approach to Evaluate Chemical Dot Thermometers for Oral Temperature Measurement

Article excerpt

Limited research has explored the accuracy of chemical dot thermometers for oral temperature measurement in adults. This study was undertaken to assess the agreement between oral temperatures taken with an electronic thermometer and single-use chemical dot thermometers in healthy women undergoing surgical delivery. During operative delivery, oral temperatures taken every 15 minutes with both the reference electronic thermometer (ETT) and a Tempa.DOT (TDT) chemical dot thermometer were compared. Data were analyzed using paired t tests, the Bland and Altman plot, and the concordance correlation coefficient. The total number of paired observations for the 62 subjects was 212. The mean difference between the two measurements was 0.35 ± 0.32 °C (p < .0001, 95% CI 0.31, 0.40). Additional analysis indicated a serious undermeasurement by TDT of ETT temperatures. Data from multiple methods of analysis indicate that the Tempa.DOT chemical dot thermometer significantly undermeasures ETT and is not a reliable indicator of oral temperature.

Keywords: evaluation studies; body temperature; thermometers; adults

In the clinical area, measurement of body temperature is an important means of determining if normothermia is being maintained or if alterations in this closely guarded mechanism are occurring. Essential to the detection of changes in temperature is the use of reliable devices. This is important for both patient convenience and from a cost perspective because temperatures indicative of hypothermia or hyperthermia generate the application of additional treatments to counteract these thermal changes (Darm, Hecker, & Rubal, 1994), many of which result in additional health care costs. Therefore, it is important that accurate and sensitive instruments for the measurement of body temperature be selected for use in health care settings. This study evaluates chemical dot thermometers for oral temperature measurement.

BACKGROUND

Multiple instruments are available for measurement of temperature in patients undergoing surgery. Although temperature-sensing pulmonary artery catheters, esophageal probes, or nasopharyngeal probes are appropriate and used for patients undergoing major surgery with general anesthetic over extended periods in the operating room (OR), they are not necessary or appropriate for patients undergoing surgery of short duration with neuraxial anesthesia. For these patients, body temperatures measured via an electronic thermometer in the posterior sublingual site in the oral cavity is more appropriate and less invasive. Also available, but used less frequently are disposable chemical dot thermometers. Although the advantages of chemical dot thermometers have been reported to outweigh their disadvantages (Buswell, 1997), limited research has investigated the accuracy of Tempa.DOT chemical dot thermometers for measurement of oral temperature in adult populations.

In one study, the accuracy of temperature measurements taken with chemical dot thermometers (Tempa.DOT) was compared with those taken orally with an electronic predictive thermometer (TempPLUS II) in 27 critically ill adults (Erickson, Meyer, & Woo, 1996). Oral readings correlated well (r = .80); however, the chemical dot thermometers provided significantly lower numerical values (MD = -0.37 ± 0.43 °C, 95% CI: -0.54, -0.20; p = .0001) compared with electronic thermometer readings. Tempa.DOT underestimated oral temperatures by -0.4 °C in 48% of subjects and overestimated it by +0.4 °C in 4%. The authors concluded that chemical dot thermometers might be useful as screening tools when more accurate methods are not appropriate. Due to their lack of sensitivity, however, they should not be used when temperature readings are important for determining the course of treatment. Additional study in various populations was recommended.

Oral temperatures taken with a chemical dot thermometer (Tempa.DOT) and with a predictive electronic thermometer (SureTemp model 678) also were compared in another study of 85 orally intubated patients (Potter, Schallom, Davis, Sona, & McSweeney, 2003). …

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