Median Door to Needle Antibiotic in Potential Febrile Neutropenic Patients in an Emergency Department of a University Metropolitan Tertiary Hospital in Barcelona (Spain): Results of an Initial Audit

Abstract

Objective: Febrile Neutropenia is a potentially life-threatening complication, which can increase morbidity and poorer clinical outcomes when first antibiotic dose is delayed in patients with potential Febrile Neutropenia (FN). Lately, is remarkably gaining consideration within the experts, aware of the prevailing poor FN guidelines compliance as reported in written literature. This research explores the ED adherence to Key Performance Indicators of ED care as indicated in evidence-based guidelines in a tertiary University Hospital in Barcelona. Methods: This is a retrospective observational cohort study of oncology patients receiving anticancer therapy in the previous 30 days of presenting to ED with: non-specific neutropenia, non-specific bacteraemia, fever, infection or septicaemia, from the 1st January 2017 until the 31st of December 2017. 166 patients were elective for the study. Results: Time to first AB dose within one hour only occurred in 16 (9.6%) of the cases. 69.3% (115) of the patients received their first AB dose within more than two hours which is non-complaint with the FN protocol. Conclusions: Evidence of some poorer outcomes accentuate an impending need to take action (implement policies, establish clinical pathways and an effective model of care) to improve FN ED management and achieve better clinical results.