Development of Tools and Processes to Improve Treatment Times in Patients With Febrile Neutropenia

Despite medical advances, febrile neutropenia remains a potentially life-threatening emergency for patients with cancer undergoing chemotherapy. A current literature review found only two oncology nursing studies addressing timeliness of antibiotic administration during a febrile neutropenic episode. Anecdotal patient reports and chart audits reflected up to a seven-hour delay in antibiotic administration for patients with febrile neutropenia presenting to the study hospital's emergency department. This article describes a multidisciplinary best practice model with tools developed for achieving timely recognition of febrile neutropenia and a one-hour benchmark for antibiotic administration at any point of entry to the hospital. Collaboration between the cancer center and emergency department provided a vehicle for critically analyzing current practice and developing effective throughput pathways. The Neutropenic Fever Team process reduced throughput to an average of 53 minutes for patients with febrile neutropenia. Educational tools were developed and used to reinforce what patients and families can do to reduce the risk of life-threatening complications. Nurses are encouraged to implement this best practice model in different settings and to investigate how throughput processes and educational tools improve clinical outcomes for this high-risk population.