Quality Initiative to Improve time to Antibiotics for Febrile Pediatric Patients with Potential Neutropenia

Pediatric Quality & Safety
Kathy MonroeLeslie Hayes

Abstract

In patients who are immunocompromised, fever may indicate a life-threatening infection. Prompt time to antibiotic administration in febrile patients at risk for neutropenia has been identified by national and international panels as a key benchmark of quality care in emergent situations. A quality improvement initiative to improve health care provided in a pediatric emergency department (ED) is described. A clinical pathway was previously initiated in a pediatric ED with a goal of improving time to antibiotics for febrile neutropenia patients. An agreed upon pathway and order set being initiated. Improvements were seen but not to the desired level. This project involved an improvement cycle that focused on nonvalue added time in the workflow. Percent of patients receiving antibiotics within the goal time of 1 hour increased from 40% to 80% with the intervention. Process measures including arrival to ED bed time, ED bed to antibiotic order time and antibiotic order time to delivery time were followed. Clinical guidelines, order sets and detailed understanding of the actual workflow at the point of care delivery can be instrumental in achieving the goals of reducing time to antibiotics.

References

Dec 7, 2007·Intensive Care Medicine·R Phillip DellingerJean-Louis Vincent
Jan 25, 2011·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Alison G Freifeld Infectious Diseases Society of America
Apr 11, 2014·BMC Health Services Research·Thomas PerronShahid Ahmed
May 4, 2016·Pediatric Emergency Care·Brandon C KuFran Balamuth

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Citations

Sep 6, 2019·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Christa KoenigBob Phillips
Jan 30, 2021·European Journal of Cancer Care·Katrina AndersonJulia E Clark
Jul 4, 2020·Pediatrics·Karina G PhangWilliam T Basco

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