Can training improve the results with infrared tympanic thermometers?

Background: Infrared tympanic thermometry (ITT) is a method for body temperature measurement. Correct measuring technique is said to be important to achieve good results with this method. The objective of this study was to investigate the accuracy and effect of training in the use of infrared tympanic thermomtry (ITT) on the measurement results. Method: Nurses trained in the use of ITT,and nurses not trained performed measurement sequences on 65 patients: one rectal and two ITT measurements in each sequence. Results: Mean rectal temperatures were significantly (P<0.01) higher than with ITT (0.44+/-0.42 (SD)degrees C for trained, 0.56+/-0.4 (SD)degrees C for untrained). Coefficient of repeatability for ITT measurements was +/-0.54 degrees C for trained nurses, and +/-0.48 degrees C for untrained. With ITT temperatures adjusted upwards of 0.5 degrees C, the sensitivity of ITT for detecting fever as defined by rectal measurements would be 70% for trained, and 54% for untrained nurses. Repeatability and sensitivity for trained and untrained nuses were not significantly (P>0.05) different. Conclusion: Training had little effect on the accuracy of the measurements. According to our results, ITT is often unreliable and should be used with caution.