Abstract
Fever in neutropenic oncology patients is an emergency that requires immediate evaluation and intervention. The total time to antibiotic (TTA) administration in pediatric oncology patients who present with fever and neutropenia is critical to improving outcomes and decreasing morbidity and mortality. Current recommendations for antibiotic administration are within 60 minutes of patient’s arrival to the emergency department (ED) (Vedi et al., 2015). The purpose of this QI project was to improve the TTA administration to <60 minutes for at >95% of fever and neutropenic patients that present to the pediatric ED. This project developed and implemented a checklist and revised current protocol to reflect evidence-based literature to meet the goal of TTA. The mean TTA pre-intervention was 42.6 minutes and 41.9 post intervention. Pre-intervention 94.1% of patients received antibiotics in <60 minutes, compared to 94.4% post intervention. In the same time period in 2019 the mean TTA was 46 minutes and only 90% of patient received antibiotics within 60 minutes. There was not a significant change in the pre and post intervention group. This pilot project had limited number of patients due to low number of pediatric patients who present with fever and neutropenia. This project needs to be continued and evaluated for months to come.