Improving Temperature Measurement Accuracy in Nursing
A quality improvement plan for medical-surgical nurses to enhance clinical accuracy in temperature measurement through staff education and standardized protocols.
Implementation and Evaluation Plan:<br>Improving Temperature Measurement Accuracy
A Quality Improvement Initiative for Medical-Surgical Nurses
Presented by Mohamed Diallo
February 15, 2026
The Challenge: Temperature Inaccuracy on Our Unit
The Clinical Problem
• Inconsistent temperature readings noted on the Medical-Surgical unit<br>• High reliance on peripheral thermometers which lack core accuracy<br>• Variability in measurement techniques among staff members<br>• Potential for delayed treatment of sepsis due to missed fevers<br>• Impact on patient outcomes and length of hospital stay<br>• Need for standardized measurement protocol identified by staff feedback
Unacceptable Variability
There is unacceptable variability in non-invasive temperature assessment methods. <br><span style="font-size: 20px; color: #666; font-weight: normal; margin-top: 10px; display: inline-block;">(Allegaert et al., 2023)</span>
"Will medical-surgical nurses who are educated on accurate temperature measurement demonstrate, on observational audit, accurate temperature taking?"
Literature Review & Evidence - Part 1
Systematic Review/Meta-Analysis
Niven et al. (2015)
Analyzed 8,682 patients demonstrating peripheral thermometers lack clinical accuracy.
Limits of agreement exceeded ±0.5°C with fever detection sensitivity at only 64%.
Although specificity was high (96%), use should be avoided when precise decisions are required.
Staff Perceptions & Barriers
Qualitative Study
Identified professional barriers including substantial knowledge gaps and low motivation.
Highlighted resource issues such as heavy workloads and lack of standardized equipment.
Revealed significant staff confusion regarding guidelines and daily task prioritization.
Literature Review & Evidence - Part 2
Continued evidence supporting the proposed practice change
TAT Competency Study
Findings & Observations
Re-education improves accuracy/competency; TAT precise only with proper technique.
Significant improvement observed in pre- vs post-intervention scores.
Standardized device use is essential for clinical reliability.
Technique & Variability
Allegaert et al. (2023)
Unacceptable variability identified in non-invasive temperature methods.
Systematic review highlights technique inconsistency; needs continuous staff re-education.
Inaccuracies negatively impact clinical workflows and cause treatment delays.
The Educational Intervention: Strategy & Objectives
Intervention Strategy
15-minute education sessions (1:1 or small groups)
Pre-test and post-test assessment methodology
Learning Objectives
Demonstrates correct probe positioning.
Explains environmental factors affecting readings.
Achieves ≥90% on post-test.
Intervention: Competency & Assessment
Evaluating Knowledge and Actionable Skills
Sample Pre/Post Test Questions
What is the primary site for core temperature approximation?
How long should you wait to measure after a patient drinks cold liquids?
What is the proper positioning for an axillary probe?
Observational Audit
Utilize a standardized competency checklist during observational audits
Focus on clarity and evaluating accurate measurement techniques
Ensure the audit imparts actionable knowledge to all clinical staff
Dissemination &<br>Implementation Strategy
Structured approaches to integrate and share new temperature measurement protocols across our healthcare unit.
Unit Updates
Share data in monthly staff and leadership meetings.
Policy Development
Draft new standardized measurement checklists.
Education
Integrate protocols into new hire nursing orientation.
Knowledge Sharing
Present at Hospital Evidence-Based Practice Committee.
Visual Communication
Digital cheat sheets and pocket guides.
Professional Growth
Poster presentation at regional nursing conference.
Thank You!
Questions & Discussion
m.diallo@nursing.org
/in/mohamed-diallo
Implementation and Evaluation Plan: Improving Temperature Measurement Accuracy
Projected Growth: Accuracy Target vs. Current Performance
Dissemination & Implementation Plan
Nursing Conference Exhibition
Unit-Level Meetings
Share project results directly with staff during regular unit meetings.
EBP Committee
Present findings to the Hospital Evidence-Based Practice Committee.
Nursing Conferences
Deliver visual poster presentations at internal and external conferences.
Policy Updates
Update and formalize unit practice policies based on accurate project data.
Digital Resources
Circulate standardized 'Best Practice' digital cheat sheets to all staff.
New Hire Orientation
Integrate new protocols directly into staff onboarding and long-term training.
References
Allegaert, K., van Dijk, M., & van den Anker, J. N. (2023). Unacceptable variability in temperature assessment methods: A systematic review. <i>Journal of Clinical Nursing</i>, 32(4), 1012-1025.
Niven, D. J., Gaudet, J. E., Syed, B. A., Laupland, K. B., Rubulotta, F., Fick, G. H., & Stelfox, H. T. (2015). Accuracy of peripheral thermometers for estimating temperature: A systematic review and meta-analysis. <i>Annals of Internal Medicine</i>, 163(10), 768-777.
Tucker, S. J. (2019). Implementation principles for evidence-based practice: Leadership, workflow, and reinforcement. <i>Implementation Science</i>, 14(1), 45-56.
- nursing-education
- quality-improvement
- clinical-accuracy
- medical-surgical-nursing
- vital-signs
- healthcare-protocol