Nurse-led study on treatment delay and streamlining antibiotic therapy among haematology patients with febrile neutropenia post chemotherapy

Abstract

Objective:The aim of the study is to identify gaps that exist among health professionals that may impact practices in caring effectively for patients with febrile neutropenia (FN).Background: Haematology patients with FN following chemotherapy frequently experience delays in antibiotic administration that may be linked to poorer clinical outcomes. To aid timely review and treatment, FN care pathways have been developed. However, observations of clinical practice and patient anecdotal reports have highlighted that the care pathways may not be adhered to. The impact on patient care outcomes due to treatment delays and the rate of protocol adherence to the FN management pathway is unknown due to insufficient evidence.Methods: Using the Clinical Records Integrated System (CRIS), data were collected by auditing patients' electronic health records (EHR) from November 2017 through to November 2018. Information retrieved were screened using the inclusion and exclusion criteria.Inclusion criteria: Haematology patients with FN (temperature ≥ 38° and neutrophil count < 1.0 x10 9 /L) post chemotherapy, and 18 years or older.Exclusion criteria: Medical oncology patients and patients who were under 17 years old. Results:The mean time for antibiotic administration from first temperature spike was 90±15 minutes for inpatients (n=48). The mean time for antibiotic administration from medical officer review was