2017
DOI: 10.1136/bmjquality.u204420.w6531
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Chasing the Golden Hour – Lessons learned from improving initial neutropenic sepsis management.

Abstract: Neutropenic sepsis remains a time critical and potentially fatal complication of systemic anti-cancer therapy. A target ‘door to needle’ time of one hour for first dose empirical intravenous antibiotics continues to be promoted nationally. A baseline audit (June 2011) highlighted shortfalls in care in the Belfast Trust, with only 15% of patients receiving antibiotics within sixty minutes. A multi-professional group within the Trust was established to try and initiate the improvements in neutropenic sepsis reco… Show more

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Cited by 9 publications
(5 citation statements)
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“…Highly successful quality improvement measures involve a high level of multidisciplinary team engagement, multiple audit and intervention cycles to overcome site‐specific barriers and significant investment of healthcare provider time (Dandoy et al, 2016; Forde & Scullin, 2017; Salstrom et al, 2015). Other studies report that in order to achieve 95% of patients achieving target time, standardised processes, a dedicated oncology contact to streamline communication and the implementation of a rapid response team with a vascular access healthcare provider were necessary (Dandoy et al, 2016).…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…Highly successful quality improvement measures involve a high level of multidisciplinary team engagement, multiple audit and intervention cycles to overcome site‐specific barriers and significant investment of healthcare provider time (Dandoy et al, 2016; Forde & Scullin, 2017; Salstrom et al, 2015). Other studies report that in order to achieve 95% of patients achieving target time, standardised processes, a dedicated oncology contact to streamline communication and the implementation of a rapid response team with a vascular access healthcare provider were necessary (Dandoy et al, 2016).…”
Section: Discussionmentioning
confidence: 99%
“…Other studies report that in order to achieve 95% of patients achieving target time, standardised processes, a dedicated oncology contact to streamline communication and the implementation of a rapid response team with a vascular access healthcare provider were necessary (Dandoy et al, 2016). In addition to care plans, education and audit, specialist nurse led antibiotic prescribing and electronic guidelines were needed before Forde and Scullin (2017) achieved >80% TTA. Novel initiatives are often resource intense and not always applicable at multiple sites.…”
Section: Discussionmentioning
confidence: 99%
“…A facilitator in expediting administration of empirical intravenous antibiotics is the implementation of a patient group direction (PGD), whereby nurses in the UK can administer the first dose of antibiotics to any patient with suspected neutropenic sepsis without a prescription [19]. This, as part of an evidence based, robust clinical pathway, has been pivotal in reducing the door to needle time of first dose antibiotic [20]. The development of ambulatory emergency care pathways for oncology patients in the UK has been recognized as a key tenet in promoting patient safety, whilst reducing pressures on Emergency Departments [21,22].…”
Section: Literature Reviewmentioning
confidence: 99%
“…It is important to recognise that 30% of patients with severe sepsis do not have fever, and patients with neutropaenia may meet sepsis criteria without being febrile, leading to delays in administration of appropriate antimicrobial therapy. 12 …”
Section: Introductionmentioning
confidence: 99%