2.50
Hdl Handle:
http://hdl.handle.net/10755/306586
Category:
Abstract
Type:
Poster
Title:
Decrease Antibiotic Administration Time for Oncology/BMT Patients with Fever
Author(s):
Volz-Noe, Pamela; Harris, Nicole; Hehman, Michelle; Dewald, Mary; Timm, Nathan; Alessandrini,Evaline; Seeberger, Lauren; Williams, Jennifer; Pomales, Jennifer
Lead Author STTI Affiliation:
Non-member
Author Details:
Pamela Volz-Noe, MEd, BSN, BS, RN, pamela.volz-noe@cchmc.org; Nicole Harris, BSN, RN; Michelle Hehman, BSN, RN; Mary Dewald, BS; Nathan Timm, MD; Evaline Alessandrini, MD; Lauren Seeberger; Jennifer Williams, MD; Jennifer Pomales, BSN, RN
Abstract:

Evidence-based Practice Abstract

Purpose: Exposing the Pediatric Oncology/BMT patient to the common communicable diseases within the Emergency Department poses a huge threat to their survival. This Rapid Cycle Improvement Collaborative project has allowed the care team to improve outcomes by providing timely and effective care to immunosuppressed patients with a fever. The goal established was identified as follows: The median time from arrival to administration of antibiotics will be decreased from 90 minutes to 60 minutes.

Design: A cross-sectional, quasi-experimental design was used.

Setting: This Rapid Cycle Improvement project was conducted in a 44-bed emergency department of an inner-city Level I Trauma Center in a Midwestern state with approximately 89,000 emergency visits per year.

Sample: All pediatric Oncology/BMT patients referred to the Emergency Department by subspecialty physician confirming a known fever of 100.4F.

Methodology: A Rapid Cycle Improvement Collaborative multidisciplinary group was formed to develop key drivers and interventions. Several PDSA Ramp Planning tools were developed and tested. A Pareto Chart was developed and modified accordingly to guide the newly implemented interventions. The median time from patient arrival to administration of antibiotics was obtained and graphed. The implemented process is as follows: Subspecialty referring physicians activate the referral process by confirmation of specified criteria. Automated paging is activated by electronic medical record notifying the emergency department attending physician and charge nurse. A pre-arrival order set that includes orders for obtaining labs and antibiotics is generated by the attending physician. The charge nurse initiates the Onc/BMT Survey Tool, which includes: reserving a room, assigning a primary nurse and ancillary staff, and completing a team huddle to discuss the plan of care. This allows ample time for preparation room and medication delivery from pharmacy. Upon arrival, an automated page is generated. The patient is immediately escorted to the reserved room where the assigned primary nurse and ancillary staff await. A quick set of vitals and review of allergies/medical history is obtained and antibiotics are immediately administered.

Results: The median time from arrival to antibiotics for referred Oncology/BMT patients with fever from 90 minutes to 60 minutes was achieved in 120 days. Within 6 months the median time was further reduced to 36 minutes.

Conclusion: In conclusion, a multi-disciplinary team was able to significantly change the outcome for the high risk Oncology/BMT population in a short amount of time. The use of the Rapid Cycle Improvement Collaborative and PDSA’s are useful tools that can be utilized to improve care of other high risk populations.

Keywords:
Time to Antibiotic Administration
Repository Posting Date:
9-Dec-2013
Date of Publication:
9-Dec-2013
Conference Date:
2013
Conference Name:
2013 ENA Annual Conference
Conference Host:
Emergency Nurses Association
Conference Location:
Nashville, Tennessee, USA
Description:
2013 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at Gaylord Resort and Convention Center
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.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePosteren_GB
dc.titleDecrease Antibiotic Administration Time for Oncology/BMT Patients with Feveren_GB
dc.contributor.authorVolz-Noe, Pamelaen_GB
dc.contributor.authorHarris, Nicoleen_GB
dc.contributor.authorHehman, Michelleen_GB
dc.contributor.authorDewald, Maryen_GB
dc.contributor.authorTimm, Nathanen_GB
dc.contributor.authorAlessandrini,Evalineen_GB
dc.contributor.authorSeeberger, Laurenen_GB
dc.contributor.authorWilliams, Jenniferen_GB
dc.contributor.authorPomales, Jenniferen_GB
dc.contributor.departmentNon-memberen_GB
dc.author.detailsPamela Volz-Noe, MEd, BSN, BS, RN, pamela.volz-noe@cchmc.org; Nicole Harris, BSN, RN; Michelle Hehman, BSN, RN; Mary Dewald, BS; Nathan Timm, MD; Evaline Alessandrini, MD; Lauren Seeberger; Jennifer Williams, MD; Jennifer Pomales, BSN, RNen_GB
dc.identifier.urihttp://hdl.handle.net/10755/306586-
dc.description.abstract<p>Evidence-based Practice Abstract</p><p>Purpose: Exposing the Pediatric Oncology/BMT patient to the common communicable diseases within the Emergency Department poses a huge threat to their survival. This Rapid Cycle Improvement Collaborative project has allowed the care team to improve outcomes by providing timely and effective care to immunosuppressed patients with a fever. The goal established was identified as follows: The median time from arrival to administration of antibiotics will be decreased from 90 minutes to 60 minutes.</p><p>Design: A cross-sectional, quasi-experimental design was used.</p><p>Setting: This Rapid Cycle Improvement project was conducted in a 44-bed emergency department of an inner-city Level I Trauma Center in a Midwestern state with approximately 89,000 emergency visits per year.</p><p>Sample: All pediatric Oncology/BMT patients referred to the Emergency Department by subspecialty physician confirming a known fever of 100.4F.</p><p>Methodology: A Rapid Cycle Improvement Collaborative multidisciplinary group was formed to develop key drivers and interventions. Several PDSA Ramp Planning tools were developed and tested. A Pareto Chart was developed and modified accordingly to guide the newly implemented interventions. The median time from patient arrival to administration of antibiotics was obtained and graphed. The implemented process is as follows: Subspecialty referring physicians activate the referral process by confirmation of specified criteria. Automated paging is activated by electronic medical record notifying the emergency department attending physician and charge nurse. A pre-arrival order set that includes orders for obtaining labs and antibiotics is generated by the attending physician. The charge nurse initiates the Onc/BMT Survey Tool, which includes: reserving a room, assigning a primary nurse and ancillary staff, and completing a team huddle to discuss the plan of care. This allows ample time for preparation room and medication delivery from pharmacy. Upon arrival, an automated page is generated. The patient is immediately escorted to the reserved room where the assigned primary nurse and ancillary staff await. A quick set of vitals and review of allergies/medical history is obtained and antibiotics are immediately administered.</p><p> Results: The median time from arrival to antibiotics for referred Oncology/BMT patients with fever from 90 minutes to 60 minutes was achieved in 120 days. Within 6 months the median time was further reduced to 36 minutes.</p><p>Conclusion: In conclusion, a multi-disciplinary team was able to significantly change the outcome for the high risk Oncology/BMT population in a short amount of time. The use of the Rapid Cycle Improvement Collaborative and PDSA’s are useful tools that can be utilized to improve care of other high risk populations.</p>en_GB
dc.subjectTime to Antibiotic Administrationen_GB
dc.date.available2013-12-09T17:00:15Z-
dc.date.issued2013-12-09-
dc.date.accessioned2013-12-09T17:00:15Z-
dc.conference.date2013en_GB
dc.conference.name2013 ENA Annual Conferenceen_GB
dc.conference.hostEmergency Nurses Associationen_GB
dc.conference.locationNashville, Tennessee, USAen_GB
dc.description2013 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at Gaylord Resort and Convention Centeren_GB
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.en_GB
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