Back to accessibility links

Paediatric Fever Management Education Program

University of Sydney
Project Added:
25 June 2014
Last updated:
10 July 2015

Paediatric Fever Management Education Program

Development of a fever management education program for parents with limited health literacy


An audio-visual presentation of modified fever management education program designed with consideration of parents and carers with varying levels of health literacy has been developed.  The program describes the best ways to assess fever in infants and children, how to manage fever dependent on the level of fever, and also when parents/carers should seek primary care or emergency services. 
The brochure and DVD are readily accessible online for parents, carers and health professionals through the Centre for Applied Nursing Research  > Education and Resources page.


The aim of this study was to develop a modified fever management education program, including a brochure and video. It is suitable for parents/carers with varying levels of health literacy.


The program aims to assist parents in the correct evaluation of a child’s fever symptoms, advising on management approaches and when to access health care services.


Fever in children is one of the major reasons why parents become concerned and seek health care assistance1, 2. Studies show that 20% of all children’s cases reporting to an ED are due to fever1,3. Further, 82% of these ED presentations are non urgent and can be managed at home or at health care centres4. The unnecessary ED presentation of a child with fever has been attributed to parents’ inability to recognise fever, limited fever knowledge and their low level of health literacy5.

Several fever management education programs have been developed to try and address the issues highlighted and have been shown to significantly improve fever knowledge and decrease concerns among parents1, 5-7. However, there are no existing education programs relating to fever management that are suitable for parents with low health literacy. This is especially relevant in Australia where 60% of the population is reported to have inadequate levels of both literacy and health literacy skills8.


The education program9 has been designed in a simple way to suit parents with varying level of health literacy through a systematic six step process.

  1. Defining the scope of health information through an extensive literature review (international evidence based practice guidelines, systematic reviews and relevant studies)
  2. Selecting the medium for presenting the information
  3. Developing pictorial images to represent key points
  4. Using plain and syntactically simple language
  5. Assessing the readability level using established tools10
  6. Reviewing the prepared material by experts to establish the content validity of the educational program.

Lead organisation

Centre for Applied Nursing Research, a joint facility of the South Western Sydney Local Health District and the University of Western Sydney.

Implementation sites

This program has been implemented at the Emergency Department Campbelltown Hospital, South Western Sydney Local Health District.

Project status

Sustained - The project has been implemented and is sustained in standard business.

This intervention may be used in a subsequent multisite clinical trial.  Further translation of the program may be undertaken in the near future.  The program is available for use by other researchers and educators after seeking written permission from the Director of the Centre for Applied Nursing Research.


The educational program resulted in increased parent/carer knowledge about fever and its management. Further, results revealed that improvement in fever knowledge and fever management practice have the potential to contribute to a reduction in the number of inappropriate Emergency Department/primary care presentations (Alqudah et al, in progress).

Lessons learnt

This audiovisual tool (DVD and Brochure) provides an easily accessible format for parents and carers with limited health literacy including poor english language skills.  The presentation using pictorial images that can easily be understood by observation for parents/carers with limited english language skills. This educational program could be used in child care facilities, community health centres, and children’s zones in libraries, although this has not been studied to date.


  1. Baker, D. W., Monroe, K. W, King, W. D, Sorrentino, A, & Glaeser, P. W. (2009). Effectiveness of Fever education in a pediatric emergency department. Pediatric Emergency Care, 25(9), 565-568.
  2. El-Radhi, A. S. (2008). Why is the evidence not affecting the practice of fever management? Archives of Disease in Childhood, 93(11), 918-920.
  3. Wammanda, R. D., & Onazi, S. O. (2009). Ability of mothers to assess the presence of fever in their children: Implication for the treatment of fever under the IMCI guidelines. Annals of African Medicine, 8(3), 173-176.
  4. Berry, A., Brousseau, D., Brotanek, J. M., Tomany-Korman, S., & Flores, G. (2008). Why Do Parents Bring Children to the Emergency Department for Nonurgent Conditions? A Qualitative Study. Ambulatory Pediatrics, 8(6), 360-367.
  5. Herman, A., Young, K. D., Espitia, D., Fu, N., & Farshidi, A. (2009). Impact of a health literacy intervention on pediatric emergency department use. Pediatric Emergency Care, 25(7), 434-438.
  6. Cohee, L. M. S., Crocetti, M. T., Serwint, J. R., Sabath, B., & Kapoor, S. (2010). Ethnic differences in parental perceptions and management of childhood fever. Clinical Pediatrics, 49(3), 221-227.
  7. Considine, Julie. (2006). Paediatric fever education for emergency nurses. Australian Nursing Journal, 14(6), 39-39.
  8. Australian Bureau of Statistics. (2006). Adult Literacy and Life Skills Survey. Retrieved 20.08.2011 from
  9. Alqudah, M., Johnson, M., Cowin, L, George, A.  (2014) An innovative Fever management education program for parents, caregivers, and emergency nurses. Advanced Emergency Nursing Journal, 36(1): 52-61.
  10. Alqudah, M., Johnson, M., Cowin, L., George, A. (2014) Measuring Health Literacy in Emergency Departments. Journal of Nursing, Education and Practice, 4(2): 1-10.


  • Mr Muhammad Alqudah, PhD candidate, University of Western Sydney
  • Professor Maree Johnson, Associate Dean Research, Faculty of Health Sciences, Australian Catholic University. Previously  Director, Centre for Applied Nursing Research, Professor of Nursing, South Western Sydney Local Health District, University of Western Sydney, Ingham Institute Applied Medical Research
  • Dr Leanne Cowin, Senior Lecturer, School of Nursing and Midwifery, University of Western Sydney
  • Dr Ajesh George, Senior Research Fellow, Centre for Applied Nursing Research, South Western Sydney Local Health District, University of Western Sydney, University of Sydney, Ingham Institute Applied Medical Research


Senior Lecturer
The Centre for Applied Nursing Research
Ingham Institute for Applied Medical Research
Phone: 02 8738 9356

Search Projects

Browse Projects

Submit your local innovation
and improvement project