A Multidisciplinary Performance Improvement Project for the Management of Febrile Neutropenia

2.50
Hdl Handle:
http://hdl.handle.net/10755/165528
Category:
Abstract
Type:
Presentation
Title:
A Multidisciplinary Performance Improvement Project for the Management of Febrile Neutropenia
Author(s):
Glynn-Tucker, Eileen
Author Details:
Eileen Glynn-Tucker, Clinical Nurse Specialist, Lake Forest Hospital, Lake Forest, Illinois, USA
Abstract:
Febrile neutropenia is a potentially life-threatening event in patients with cancer. Prompt multidisciplinary care should include evaluation for sources of infection, prompt initiation of antibiotic therapy, and use of other interventions to reduce possible sources of infection. A retrospective chart analysis of patients admitted with febrile neutropenia was performed to evaluate the care delivered in a community hospital setting. The retrospective review indicated delays in initiation of antibiotics, inconsistent antibiotic selection, and lengthy stays in the emergency department. Furthermore, inconsistent practices in dietary restrictions and isolation practices were observed in patients hospitalized with neutropenia. These findings confirmed the need for a multidisciplinary process improvement team. The goal of the initiative was to promptly recognize and treat patients with febrile neutropenia by providing multidisciplinary clinicians with the necessary tools and education. A policy outlining care of patients with neutropenia including definitions, culturing recommendations, dietary practices, and hand washing/isolation practices was instituted. Standing admission orders (including growth factors, antipyretics, and culturing recommendations) and initial antibiotic orders were developed. The policy and standing orders were presented for approval at appropriate hospital committees and interdisciplinary inservicing was provided as part of the implementation plan. Registered nurses and patient care technicians were also inserviced about neutropenia and febrile neutropenia using pertinent information from the ONS ATAQ initiative and a review of the literature. Quality monitoring was conducted to assess the effectiveness of the quality improvement project. Antibiotic selection is appropriate and time-to-antibiotic administration has been reduced. Growth factors are also initiated in a timely manner. The standing admission orders are activated appropriately in the emergency department or on the inpatient acute care unit. Thus, the quality monitoring findings indicate that the project's goals were met. In conclusion, a multidisciplinary team can effectively reduce the life-threatening effects of neutropenia by recognizing system limitations and working to correct them with non-cumbersome solutions. Oncology nurses and patients benefit from this process improvement project. Further areas to examine are early identification of clients at risk for neutropenia in the emergency department and prevention of recurrent episodes of febrile neutropenia.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2002
Conference Name:
27th Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
Washington, D.C., USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleA Multidisciplinary Performance Improvement Project for the Management of Febrile Neutropeniaen_GB
dc.contributor.authorGlynn-Tucker, Eileenen_US
dc.author.detailsEileen Glynn-Tucker, Clinical Nurse Specialist, Lake Forest Hospital, Lake Forest, Illinois, USAen_US
dc.identifier.urihttp://hdl.handle.net/10755/165528-
dc.description.abstractFebrile neutropenia is a potentially life-threatening event in patients with cancer. Prompt multidisciplinary care should include evaluation for sources of infection, prompt initiation of antibiotic therapy, and use of other interventions to reduce possible sources of infection. A retrospective chart analysis of patients admitted with febrile neutropenia was performed to evaluate the care delivered in a community hospital setting. The retrospective review indicated delays in initiation of antibiotics, inconsistent antibiotic selection, and lengthy stays in the emergency department. Furthermore, inconsistent practices in dietary restrictions and isolation practices were observed in patients hospitalized with neutropenia. These findings confirmed the need for a multidisciplinary process improvement team. The goal of the initiative was to promptly recognize and treat patients with febrile neutropenia by providing multidisciplinary clinicians with the necessary tools and education. A policy outlining care of patients with neutropenia including definitions, culturing recommendations, dietary practices, and hand washing/isolation practices was instituted. Standing admission orders (including growth factors, antipyretics, and culturing recommendations) and initial antibiotic orders were developed. The policy and standing orders were presented for approval at appropriate hospital committees and interdisciplinary inservicing was provided as part of the implementation plan. Registered nurses and patient care technicians were also inserviced about neutropenia and febrile neutropenia using pertinent information from the ONS ATAQ initiative and a review of the literature. Quality monitoring was conducted to assess the effectiveness of the quality improvement project. Antibiotic selection is appropriate and time-to-antibiotic administration has been reduced. Growth factors are also initiated in a timely manner. The standing admission orders are activated appropriately in the emergency department or on the inpatient acute care unit. Thus, the quality monitoring findings indicate that the project's goals were met. In conclusion, a multidisciplinary team can effectively reduce the life-threatening effects of neutropenia by recognizing system limitations and working to correct them with non-cumbersome solutions. Oncology nurses and patients benefit from this process improvement project. Further areas to examine are early identification of clients at risk for neutropenia in the emergency department and prevention of recurrent episodes of febrile neutropenia.en_GB
dc.date.available2011-10-27T12:20:16Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:20:16Z-
dc.conference.date2002en_US
dc.conference.name27th Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationWashington, D.C., USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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