Febrile Neutropenia Decreasing time to antibiotic administration in a community hospital emergency department

Abstract

to antibiotic administration guideline. Key areas of improvement and evidence-based strategies were identified (see Table 1). As monthly meetings were established with emergency department and oncology nursing leadership, the CNS performed case reviews of all emergency department admissions of patients with febrile neutro-penia. The case reviews facilitated a root cause analysis of delays in time to antibiotic administration. Identified issues were included for discussion during monthly meetings, and strategies were developed. The emergency department medical director followed up on all physician issues, particularly those cases in which antibiotics other than the standardized protocol were prescribed. A learning need was identified on the part of the emergency department staff who did not have a clear understanding of febrile neutrope-nia, the urgent need for management in patients with cancer with febrile neutro-penia, or awareness of relevant guidelines. This lack of understanding highlights the need for staff education to ensure guideline implementation in practice.