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Comparative Evaluation of Non-Mercury Thermometers in a Hospital Setting and Healthcare Staff Preferences EcOrient & 4 th Lebanon Sustainability Week Conference June 6, 2012. Literature. incomprehensive and inconclusive
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Comparative Evaluation of Non-Mercury Thermometers in a Hospital Setting and Healthcare Staff PreferencesEcOrient & 4th Lebanon Sustainability Week Conference June 6, 2012
Literature • incomprehensive and inconclusive • difficult for meta-analysis because studies target different patient populations and utilize a variety of devices • Overall, electronic thermometers have the widest support as reliable, accurate, and safe alternatives to mercury thermometers. The problem is that they are thought to be expensive Crawford, D. C., Hicks, B., & Thompson, M. J. (2006). Which thermometer? Factors influencing best choice for intermittent clinical temperature assessment. Journal of Medical Engineering & Technology, 30(4), 199 – 211.
Research Methods • Market survey • Nursing leadership preferences • Comparative costing • Clinical comparison - comparative accuracy - ease of use • Nursing staff perspective
Selection of the two non-mercury thermometers • Market survey of mercury-free thermometers 10 brands compact electronic, one single brand electronic, 5 brands infrared tympanic, 3 brands infrared temporal, and one brand Galinstan-in-glass. • Nursing Leadership Preferences Analysis of preferred criteria showed that the selected thermometer should display the result digitally and have the ability to measure the temperature from different sites.
Selection of the two non-mercury thermometers • Electronic Suretemp Plus 690 (Welch Allyn – USA)
Selection of the two non-mercury thermometers • Compact Electronic 10 brands Peak temperature alarmFever warning Flexible probe tip Start-up self-check Memory function Meet standards MT 200 (Microlife, Switzerland)
Evaluating Accuracy of the Two Alternative Thermometers • 150 readings from five clinical departments (30 each) • Measurement sites included oral cavity (40 %), axilla (40%), and rectum (20%) • 62% of readings were taken on female patients
Evaluating Ease of Use of the Two Alternative Thermometers • Ten healthcare staff (RNs & PNs) took the temperature of a volunteer three times by each thermometer.
Healthcare personnel perspective • Five healthcare personnel (practical nurses) • Five days
Healthcare personnel perspective “The nylon probe covers of the MT200 are not enough protection from nosocomial infections since micro-tears may happen to the probe cover during measurement which might affect its integrity.” “Equipments used on isolation patients are kept in their rooms, which might increase the possibility of loosing the MT200 because of its small size.” “Removal of the probe cover of MT200 may pose a risk of contamination.” “Probes of electronic thermometer are thick causing discomfort for the neonates.”
Recommendations • Electronic thermometers are the most cost-effective type of thermometers in the Lebanese setting. • Compact electronic thermometers cannot replace electronic thermometers from the accuracy point of view. • Electronic thermometers are easier to use than compact electronic thermometers. • Most of healthcare personnel's comments favor the electronic thermometer. • The Electronic thermometer is the recommended replacement for the mercury thermometer in Lebanon.