Optimizing Time to Antibiotic Administration in Children with Possible Febrile Neutropenia through Quality...

Area of Science:

• Pediatric Oncology
• Infectious Diseases
• Quality Improvement Science

Background:

• Febrile neutropenia is a serious chemotherapy complication in children.
• Timely antibiotic treatment is vital for reducing morbidity and mortality.
• A <60-minute time to antibiotic (TTA) administration is a key quality metric.

Purpose of the Study:

• To implement a quality improvement initiative to achieve TTA < 60 minutes in >80% of eligible pediatric oncology patients.
• To enhance the promptness of antibiotic delivery in a pediatric emergency department setting.

Main Methods:

• Utilized Plan-Do-Study-Act (PDSA) cycles to streamline antibiotic ordering and preparation.
• Focused on reducing time from patient arrival to antibiotic order.
• Implemented pharmacy expediting and pre-arrival ordering strategies.
• Employed statistical process control for outcome measurement.

Main Results:

• Mean TTA decreased from 64 to 53 minutes post-intervention.
• Percentage of patients receiving antibiotics within <60 minutes increased from 59% to 84%.
• Sustained improvements were observed, with 85% of patients receiving antibiotics within the goal time.

Conclusions:

• A multi-cycle PDSA initiative effectively reduced TTA in pediatric febrile neutropenia patients.
• The initiative significantly increased the proportion of patients receiving timely antibiotic therapy.
• The quality improvement strategy successfully met and sustained the <60-minute TTA benchmark.