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Multicentre Delphi study of physicians resulted in quality indicators for young infants with fever without source in

Roberto Velasco1, Ainara Lejarzegi2, David Andina3

  • 1Paediatric Emergency Department, Hospital Universitario Rio Hortega, Valladolid, Spain.

Acta Paediatrica (Oslo, Norway : 1992)
|May 19, 2023
PubMed

Insights

This study developed quality indicators for managing febrile infants under 90 days old in emergency departments (EDs). Essential indicators include having a protocol, urinalysis, blood cultures, and prompt antibiotic administration for ill-appearing infants.

Area of Science:

  • Pediatrics
  • Emergency Medicine
  • Quality Improvement

Background:

  • Managing febrile infants without a clear source lacks a standardized approach.
  • There is a need for defined quality indicators in pediatric emergency care.

Purpose of the Study:

  • To establish quality indicators for the emergency department (ED) management of infants up to 90 days old presenting with fever without source.
  • To create a consensus-based standard of care for this vulnerable population.

Main Methods:

  • A multicenter Delphi study involving 24 Spanish EDs and pediatric emergency physicians.
  • Indicators were selected based on expert consensus (≥4 score from 95% of investigators) and panel voting.

Main Results:

  • Twenty quality indicators were established, covering protocols, triage, diagnostics, treatment, and disposition.
  • Essential indicators include having an ED management protocol, performing urinalysis and blood cultures on all infants, and administering antibiotics to ill-appearing febrile infants.

Conclusions:

  • The Delphi method successfully generated a comprehensive set of quality indicators for managing febrile infants in Spanish EDs.
  • These indicators aim to improve the consistency and quality of care for febrile infants.
Abstract

Keywords:
bacterial infectionemergencyfeverinfantquality

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