Neutropenic fever: one institution's quality improvement project to decrease time from patient arrival to initiation...

Area of Science:

• Oncology
• Quality Improvement Science
• Clinical Nursing

Background:

• Febrile neutropenia is a critical oncologic emergency requiring immediate antibiotic treatment.
• Early antibiotic initiation significantly improves clinical outcomes for patients with febrile neutropenia.
• The oncology team at Dartmouth-Hitchcock Medical Center identified delays in antibiotic administration for adult inpatients.

Purpose of the Study:

• To decrease treatment delays by reducing the cycle time to initial antibiotic doses for adult inpatients with febrile neutropenia.

Main Methods:

• A multidisciplinary team analyzed the existing patient admission process.
• Key areas for improvement identified were inpatient orders, communication processes, and staff accountability.
• A quality improvement initiative was implemented based on these findings.

Main Results:

• A chart review was conducted post-implementation to assess changes in antibiotic administration time.
• The study revealed a significant reduction in the cycle time for initiating antibiotics.
• Nearly a 50% decrease in treatment delays was observed on the inpatient unit.

Conclusions:

• Targeted interventions addressing system-level issues can effectively reduce critical treatment delays.
• Optimizing the admission process is key to improving timely care for oncologic emergencies like febrile neutropenia.
• This quality improvement project demonstrated a substantial enhancement in patient care delivery for febrile neutropenia.