Date of Completion of Thesis/SIP

2022

Document Type

Scholarly Inquiry Paper (SIP)

Degree Name

Master of Science in Nursing (MSN)

Department

Nursing

First Advisor

Diane Forsyth

Second Advisor

Ann Loth

City

Winona

Abstract

Introduction to the Problem: Prescribers in the acute care setting differ in opinions with the role fever plays with stroke patient outcomes. This is evident by contrasting guideline recommendations and differing plan of care development amongst prescribers. This lack of clarity has led to the question; does fever affect stroke patient outcomes in that acute care setting.

Supporting Literature: The research utilized for this inquiry was specific to both ischemic and hemorrhagic stroke patient outcomes when fever is present.

Methods Used for Inquiry: An integrative literature review was conducted for this inquiry. A total of ninety articles were reviewed, with twenty-one selected. The literature review was conducted over material from the years 2000 to the present. The databases utilized to find the research for this inquiry included CINAHL, PubMed, and Cochrane libraries.

Strength of Evidence: The strength of evidence utilized for this inquiry was a rating scheme of one to five. This inquiry included six systematic reviews or meta-analysis, one randomized controlled-trial, five prospective non-randomized trials, and nine retrospective comparative studies.

Conclusion: Stroke patient outcomes were found to be significantly worse when fever is present. Diminished patient outcomes were found in both ischemic and hemorrhagic stroke populations. This was measured by poor functional outcomes, increased stroke severity, increased hospital length of stay, elevated pro-inflammatory markers, larger infarction volume, and larger hematoma volumes. The highest presence of fever was found in subarachnoid and intra-ventricular hemorrhage patient populations. Fever threshold was identified with a range from 37-38.5C. Treatment options for febrile stroke patients were inconclusive and further data is needed to strengthen the argument for appropriate therapies. Additional research is needed regarding treatment intervention for fevers for stroke patients.

Comments

ACKNOWLEDGEMENT

Diane Forsyth

Your guidance and supervision throughout this inquiry process has forever changed how I understand research. You have taught me a skill that will forever shape my clinical practice. Thank you for insight for I will be forever grateful.

Anne Loth

The journey through this inquiry process has been both challenging and rewarding. Your support and belief in my abilities has been a source of strength that has helped me through this research process. Thank you for your undoubting encouragement and guidance.

Angela Grant

To my wife, lifelong partner, and mother of my three special children. There are no words to describe how thankful I am for your support throughout this entire process. This would have not been achievable without you by my side. I am both blessed and eternally grateful to have you in my life. I cannot express this enough but thanks for everything you do.

Included in

Nursing Commons

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