2.50
Hdl Handle:
http://hdl.handle.net/10755/162440
Type:
Presentation
Title:
Hot Tot
Abstract:
Hot Tot
Conference Sponsor:Emergency Nurses Association
Conference Year:2011
Author:Quon, Tina, RN, MSN, CNS, CEN, CPEN
P.I. Institution Name:University of California San Francisco Medical Center
Title:Clinical Nurse Specialist
Contact Address:505 Parnassus Avenue, San Francisco, CA, 94117, USA
Contact Telephone:415-353-1444
Co-Authors:James O'Brien, RN, PCM; Dorene Prudden, RN, BC
[ENA Leadership Conference] Evidence-based Practice Presentation: Hot Tot

Purpose: The ED received low patient satisfaction scores regarding length of stay from the Pediatric Hematology/Oncology families. The Pediatric Oncology manager and ED CNS investigated the sources of complaints and reviewed guidelines to provide optimal care and management of pediatric oncology patients with fever and neutropenia (F&N). We created a multidisciplinary team of oncology physicians, nurses and pharmacists to develop an algorithm that would guide the practice of the ED, and set a goal of one hour for completing tasks, and expedite F&N patients to the Pediatric Oncology unit.

Design: When our multidisciplinary team met, our primary concerns were patient safety and meeting the special needs of this patient population. Our goal was to assure that the patients were properly triaged, obtain immediate blood cultures, administer antibiotics, and initiate an expedited algorithm for patient transfer to the oncology unit. An ED staff development project was implemented to educate the ED nursing staff on F&N. We related total ED admission time to patient care and outcomes. We examined patient needs assessment and best-case scenarios

Participants: All pediatric oncology patients with F&N who present to the ED.

Setting: An adult and pediatric tertiary referral and academic medical center that includes a Children's Hospital.

Methods: We developed and implemented an ED F&N bundle, performed retrospective chart reviews, and maintained a collaborative multidisciplinary team of oncology and ED nurses, managers, and CNS. We defined our goal time of one hour for "Door to Antibiotics", and expedited transfer to the pediatric Oncology unit. We identified ED knowledge deficits regarding F&N timelines, and nursing implications for obtaining blood cultures. We developed a patient survey for this population to determine if we've made a positive impact on patient/parent satisfaction.

Results/Outcomes: We are collecting data on our F&N patients that present to the ED. We are reviewing "Door to blood cultures," "Door to Antibiotics," and "Door to Admission" time intervals. An 8 month review showed a significant reduction in antibiotic delays. There is heightened awareness among ED nursing staff regarding F&N and septic shock, and our ED nursing staff was empowered to change current pediatric processes.

Implications: We knew that all healthcare providers regardless of where they work want to provide the best possible care to their patients. What we discovered was that small specialized patient populations received more efficient and timely care if there were guidelines of the exact care that is needed. We have implemented and built the F&N bundle into our ED orientation and ED annual competency skills day.
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleHot Toten_GB
dc.identifier.urihttp://hdl.handle.net/10755/162440-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Hot Tot</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2011</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Quon, Tina, RN, MSN, CNS, CEN, CPEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of California San Francisco Medical Center</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Clinical Nurse Specialist</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">505 Parnassus Avenue, San Francisco, CA, 94117, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">415-353-1444</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">tina.quon@ucsfmedctr.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">James O'Brien, RN, PCM; Dorene Prudden, RN, BC</td></tr><tr><td colspan="2" class="item-abstract">[ENA Leadership Conference] Evidence-based Practice Presentation: Hot Tot<br/><br/>Purpose: The ED received low patient satisfaction scores regarding length of stay from the Pediatric Hematology/Oncology families. The Pediatric Oncology manager and ED CNS investigated the sources of complaints and reviewed guidelines to provide optimal care and management of pediatric oncology patients with fever and neutropenia (F&amp;N). We created a multidisciplinary team of oncology physicians, nurses and pharmacists to develop an algorithm that would guide the practice of the ED, and set a goal of one hour for completing tasks, and expedite F&amp;N patients to the Pediatric Oncology unit.<br/><br/>Design: When our multidisciplinary team met, our primary concerns were patient safety and meeting the special needs of this patient population. Our goal was to assure that the patients were properly triaged, obtain immediate blood cultures, administer antibiotics, and initiate an expedited algorithm for patient transfer to the oncology unit. An ED staff development project was implemented to educate the ED nursing staff on F&amp;N. We related total ED admission time to patient care and outcomes. We examined patient needs assessment and best-case scenarios<br/><br/>Participants: All pediatric oncology patients with F&amp;N who present to the ED.<br/><br/>Setting: An adult and pediatric tertiary referral and academic medical center that includes a Children's Hospital.<br/><br/>Methods: We developed and implemented an ED F&amp;N bundle, performed retrospective chart reviews, and maintained a collaborative multidisciplinary team of oncology and ED nurses, managers, and CNS. We defined our goal time of one hour for &quot;Door to Antibiotics&quot;, and expedited transfer to the pediatric Oncology unit. We identified ED knowledge deficits regarding F&amp;N timelines, and nursing implications for obtaining blood cultures. We developed a patient survey for this population to determine if we've made a positive impact on patient/parent satisfaction.<br/><br/>Results/Outcomes: We are collecting data on our F&amp;N patients that present to the ED. We are reviewing &quot;Door to blood cultures,&quot; &quot;Door to Antibiotics,&quot; and &quot;Door to Admission&quot; time intervals. An 8 month review showed a significant reduction in antibiotic delays. There is heightened awareness among ED nursing staff regarding F&amp;N and septic shock, and our ED nursing staff was empowered to change current pediatric processes. <br/><br/>Implications: We knew that all healthcare providers regardless of where they work want to provide the best possible care to their patients. What we discovered was that small specialized patient populations received more efficient and timely care if there were guidelines of the exact care that is needed. We have implemented and built the F&amp;N bundle into our ED orientation and ED annual competency skills day.<br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:28:15Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:28:15Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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