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Quality Initiative to Improve time to Antibiotics for Febrile Pediatric Patients with Potential Neutropenia
INTRODUCTION: In patients who are immunocompromised, fever may indicate a life-threatening infection. Prompt time to antibiotic administration in febrile patients at risk for neutropenia has been identified by national and international panels as a key benchmark of quality care in emergent situation...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6135558/ https://www.ncbi.nlm.nih.gov/pubmed/30229205 http://dx.doi.org/10.1097/pq9.0000000000000095 |
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author | Monroe, Kathy Cohen, Clay T. Whelan, Kimberly King, Amber Maloney, Lisa Deason, Janet Nichols, John Charles Friedman, Gregory K. Kutny, Matthew Hayes, Leslie |
author_facet | Monroe, Kathy Cohen, Clay T. Whelan, Kimberly King, Amber Maloney, Lisa Deason, Janet Nichols, John Charles Friedman, Gregory K. Kutny, Matthew Hayes, Leslie |
author_sort | Monroe, Kathy |
collection | PubMed |
description | INTRODUCTION: In patients who are immunocompromised, fever may indicate a life-threatening infection. Prompt time to antibiotic administration in febrile patients at risk for neutropenia has been identified by national and international panels as a key benchmark of quality care in emergent situations. A quality improvement initiative to improve health care provided in a pediatric emergency department (ED) is described. METHODS: A clinical pathway was previously initiated in a pediatric ED with a goal of improving time to antibiotics for febrile neutropenia patients. An agreed upon pathway and order set being initiated. Improvements were seen but not to the desired level. This project involved an improvement cycle that focused on nonvalue added time in the workflow. RESULTS: Percent of patients receiving antibiotics within the goal time of 1 hour increased from 40% to 80% with the intervention. Process measures including arrival to ED bed time, ED bed to antibiotic order time and antibiotic order time to delivery time were followed. CONCLUSION: Clinical guidelines, order sets and detailed understanding of the actual workflow at the point of care delivery can be instrumental in achieving the goals of reducing time to antibiotics. |
format | Online Article Text |
id | pubmed-6135558 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-61355582018-09-18 Quality Initiative to Improve time to Antibiotics for Febrile Pediatric Patients with Potential Neutropenia Monroe, Kathy Cohen, Clay T. Whelan, Kimberly King, Amber Maloney, Lisa Deason, Janet Nichols, John Charles Friedman, Gregory K. Kutny, Matthew Hayes, Leslie Pediatr Qual Saf Individual QI Projects from Single Institutions INTRODUCTION: In patients who are immunocompromised, fever may indicate a life-threatening infection. Prompt time to antibiotic administration in febrile patients at risk for neutropenia has been identified by national and international panels as a key benchmark of quality care in emergent situations. A quality improvement initiative to improve health care provided in a pediatric emergency department (ED) is described. METHODS: A clinical pathway was previously initiated in a pediatric ED with a goal of improving time to antibiotics for febrile neutropenia patients. An agreed upon pathway and order set being initiated. Improvements were seen but not to the desired level. This project involved an improvement cycle that focused on nonvalue added time in the workflow. RESULTS: Percent of patients receiving antibiotics within the goal time of 1 hour increased from 40% to 80% with the intervention. Process measures including arrival to ED bed time, ED bed to antibiotic order time and antibiotic order time to delivery time were followed. CONCLUSION: Clinical guidelines, order sets and detailed understanding of the actual workflow at the point of care delivery can be instrumental in achieving the goals of reducing time to antibiotics. Wolters Kluwer Health 2018-08-09 /pmc/articles/PMC6135558/ /pubmed/30229205 http://dx.doi.org/10.1097/pq9.0000000000000095 Text en Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Individual QI Projects from Single Institutions Monroe, Kathy Cohen, Clay T. Whelan, Kimberly King, Amber Maloney, Lisa Deason, Janet Nichols, John Charles Friedman, Gregory K. Kutny, Matthew Hayes, Leslie Quality Initiative to Improve time to Antibiotics for Febrile Pediatric Patients with Potential Neutropenia |
title | Quality Initiative to Improve time to Antibiotics for Febrile Pediatric Patients with Potential Neutropenia |
title_full | Quality Initiative to Improve time to Antibiotics for Febrile Pediatric Patients with Potential Neutropenia |
title_fullStr | Quality Initiative to Improve time to Antibiotics for Febrile Pediatric Patients with Potential Neutropenia |
title_full_unstemmed | Quality Initiative to Improve time to Antibiotics for Febrile Pediatric Patients with Potential Neutropenia |
title_short | Quality Initiative to Improve time to Antibiotics for Febrile Pediatric Patients with Potential Neutropenia |
title_sort | quality initiative to improve time to antibiotics for febrile pediatric patients with potential neutropenia |
topic | Individual QI Projects from Single Institutions |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6135558/ https://www.ncbi.nlm.nih.gov/pubmed/30229205 http://dx.doi.org/10.1097/pq9.0000000000000095 |
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