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Impact of the Step-by-Step on febrile infants

Borja Gomez1,2, Amaia Fernandez-Uria3, Javier Benito3,2

  • 1Pediatric Emergency Department, Cruces University Hospital, Barakaldo, País Vasco, Spain borja.gomezcortes@osakidetza.eus.

Archives of Disease in Childhood
|August 19, 2021
PubMed

Insights

The Step-by-Step approach improved care quality for young febrile infants by increasing adherence to guidelines and sepsis evaluations. Invasive bacterial infection rates remained unchanged, indicating enhanced safety and efficiency in pediatric emergency care.

Area of Science:

  • Pediatrics
  • Emergency Medicine
  • Infectious Diseases

Background:

  • Fever without source in infants under 90 days old presents a diagnostic challenge.
  • Standardized approaches are crucial for optimizing care quality and resource utilization.

Purpose of the Study:

  • To assess the impact of the Step-by-Step approach on the quality of care for febrile infants.
  • To evaluate changes in adherence to recommendations, resource use, and safety.

Main Methods:

  • Observational study comparing infants before and after Step-by-Step implementation.
  • Data collected from a pediatric emergency department over a 5-year period.
  • Analysis focused on adherence, resource utilization (lumbar puncture, admission, antibiotics), and safety outcomes.

Main Results:

  • Increased adherence to urine and blood tests (84.7% to 91.0%) and sepsis evaluations for young infants (23.9% to 63.3%).
  • Decreased rates of lumbar puncture (24.1% to 18.7%) and hospital admission (43.6% to 38.3%).
  • Increased antibiotic therapy rates (30.2% to 43.2%) with unchanged invasive bacterial infection rates (0.7% to 0.3%).

Conclusions:

  • The Step-by-Step approach significantly enhanced the quality of care for young febrile infants.
  • The protocol improved adherence and resource management without compromising safety.
Abstract

Keywords:
emergency carepaediatric emergency medicinepaediatrics

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