Nursing Practice for Temperature Control During Continuous Kidney Replacement Therapy in Intensive Care: A Cross-Sectional Study.

BACKGROUND

Hypothermia during continuous kidney replacement therapy is associated with increased mortality and morbidity.

OBJECTIVES

The primary aim was to describe nursing practice for assessment and management of temperature control for patients receiving continuous kidney replacement therapy in intensive care. Secondary aims were to compare nurses' level of confidence, and assessment and management practices for temperature control, during continuous kidney replacement therapy by participant characteristics.

DESIGN

Cross-sectional comparative study.

PARTICIPANTS

Intensive care nurses completed an online survey.

MEASUREMENTS: The newly developed survey included 23 items. Descriptive and inferential statistics for demographic information, temperature assessment and management practices, and confidence levels were analysed.

RESULTS

The sample included 155 participants. Only 10% of participants reported managing continuous kidney replacement therapy at least once per week, and half (48%) less than once per month. Temperature assessment within the first hour of therapy was reported by 70% of participants. Hourly temperature assessments were reported by 36%, and 32% reported 4-hourly temperature assessment. Non-invasive temperature assessment (e.g., tympanic) was the most frequently reported mode of temperature assessment (64%). The mean confidence level was 3.94 (standard deviation = 1.08) out of 5. Confidence levels were higher for nurses with more years of experience and those with increased exposure to continuous kidney replacement therapy.

CONCLUSIONS

Variation in nursing practice for temperature control in patients receiving continuous kidney replacement therapy was identified. Guidelines and educational strategies are required to inform nursing practice to address variation in practice and confidence.