Esophageal Temperature Probes in Targeted Temperature Management

Abstract

Purpose: This DNP quality improvement project aimed to increase intent to change practice among nurses in the medical intensive care unit regarding temperature monitoring in patients undergoing targeted temperature management (TTM) after a cardiac arrest.Background: Although many different methods of core temperature have been used to monitor temperature in patients undergoing TTM, esophageal is most closely related to pulmonary artery catheter. Pulmonary artery catheters most accurately represent temperatures in the brain. Cooling a patient after a cardiac arrest decreases metabolic needs of the brain, stops further cell death in the brain after lack of oxygen, and decreases inflammation in the brain. Methods Design: An email was sent to nurses in the Medical Intensive Care Unit (MICU) with a link to educational material and a post-learning survey. Optional in-person rounding was provided twice on the day shift and twice on the night shift. Setting: Banner University Medical Center-Phoenix, a 746-bed not-for-profit hospital in Phoenix, Arizona, Banner Health’s flagship hospital. The project’s focus was in the 54-bed medical intensive care unit (MICU). Participants: Participants included core staff nurses in the MICU, and participation was voluntary. The link was sent out to approximately100 nurses, with sixteen nurses responding. Measurements: Six knowledge retention questions were included in the survey. Four questions used the Likert scale on how they felt about the education and their intent to change practice. One question was regarding the length of time as a nurse, and one question was if they had their Critical Care Registered Nurse (CCRN) certification. There was also one open-ended question regarding barriers to implementation. Results: The results showed that nurses agreed and strongly agreed that the education was beneficial, and they had an increase in intent to change practice. The results also showed no statistically significant difference incorrect answers when comparing CCRN nurses to non-CCRN nurses, no statistically significant difference in years of nursing, and correct answers. Conclusions: Although the sample size was small, education on esophageal temperature probes increased the intent to change practice among nurses in the MICU.