Fever notions of the misinformed: a quality improvement project

Area of Science:

• Internal Medicine
• Infectious Diseases
• Hospital Quality Improvement

Background:

• Modern hospital care often neglects graphical temperature tracking and understanding normal diurnal variations.
• Fever is frequently misperceived as solely detrimental, ignoring its role as a beneficial physiological response to infection.
• Injudicious antibiotic use for low-grade fever is a significant driver of antimicrobial resistance and Clostridium difficile infections.

Purpose of the Study:

• To highlight the decline in recognizing normal temperature variations and fever's beneficial role in hospital settings.
• To address the contribution of unnecessary antibiotic prescriptions for low-grade fever to public health crises.
• To propose a quality improvement initiative focused on correcting common misperceptions about fever.

Main Methods:

• Literature review and analysis of current hospital practices regarding fever management.
• Discussion of the physiological role of fever in combating infection.
• Proposal of a quality improvement project to re-educate healthcare providers on fever's significance.

Main Results:

• Modern medical practice has lost the nuanced understanding of fever and its graphical tracking.
• Over-prescription of antibiotics for fever exacerbates the development of multidrug-resistant organisms (MDROs) and Clostridium difficile.
• A shift in perception is needed to view fever as a potentially beneficial host defense mechanism.

Conclusions:

• Revisiting the graphical monitoring of temperature and understanding diurnal variations is crucial.
• Antibiotic stewardship is essential to combatting antimicrobial resistance and C. difficile.
• Changing the perception of fever from a negative sign to a potentially beneficial response is a vital quality improvement goal.