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Improving Time to Antibiotic Administration for Bone Marrow Transplant Patients With First Fever

Paulina Daniels1, Abigail Pate2, Laura Flesch2

  • 1Divisions of Bone Marrow Transplantation and Immune Deficiency and pauline.daniels@cchmc.org.

Pediatrics
|December 22, 2017
PubMed
Abstract

Insights

Reducing antibiotic administration time for bone marrow transplant patients with fever significantly improved outcomes. Our interventions decreased the mean time from 75 to 45 minutes, exceeding the 60-minute goal.

Area of Science:

  • Hematology
  • Infectious Diseases
  • Quality Improvement

Background:

  • Timely antibiotic administration is critical for immunocompromised patients.
  • Hospitalized bone marrow transplant (BMT) patients with fever require prompt treatment.
  • Current delays in antibiotic administration impact patient outcomes.

Purpose of the Study:

  • To decrease the mean time to antibiotic administration in febrile BMT patients.
  • To reduce the time from fever onset to antibiotic delivery from 75 minutes to under 60 minutes.

Main Methods:

  • Utilized the Model of Improvement with plan-do-study-act cycles.
  • Implemented nursing, physician, and pharmacy interventions.
  • Focused on high-reliability interventions to expedite antibiotic delivery.

Main Results:

  • Achieved a decrease in mean antibiotic administration time from 75 to 45 minutes.
  • Increased the percentage of patients receiving antibiotics within 60 minutes from 40% to over 90%.
  • Key interventions included standardized order sets, direct pharmacy notifications, and prioritized delivery.

Conclusions:

  • A standardized process for fever notification and prioritized antibiotic preparation improves administration times.
  • Timely antibiotic order entry is crucial for febrile BMT patients.
  • The implemented interventions successfully reduced antibiotic administration delays in this vulnerable population.

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