Management Of Neutropenic Sepsis Research Articles

Virtual ward: The future in the management of neutropenic sepsis in the NHS

Virtual ward offers patients with neutropenic sepsis a unique opportunity to receive hospital level of care in the comfort of their home, especially for patients who would otherwise be admitted to hospital because of their acute treatment. On the virtual ward, patients can receive hospital level of care with a significant opportunity to mitigate any risk of hospital-acquired infection in this subset of patients who are already immunocompromised amongst other benefits. Additionally, hospital length of stay can be shortened leading to reduced admission pressure in hospitals, increasing hospital admission avoidance, and encouraging safe discharge from hospital while still providing the best care for the patients. We report a case of a 76-year-old cancer patient who presented with neutropenic sepsis and was successfully managed on the virtual ward in a district hospital. This case highlights the importance of virtual wards an evolving innovation that can define the future management of cancer patients in NHS. It is safe and reduces the cost of inpatient care in healthcare.

British Society for Haematology guidelines for the management of adult myelodysplastic syndromes.

British Society for Haematology guidelines for the management of adult myelodysplastic syndromes.

Neutropenic sepsis.

What was the nature of the CPD activity, practice-related feedback and/or event and/or experience in your practice? The CPD article discussed the symptoms, treatment and prevention of neutropenic sepsis, which is a potentially life-threatening complication of chemotherapy.

The introduction of an acute physiological support service for surgical patients is an effective error reduction strategy

IntroductionAcute surgical patients are particularly vulnerable to human error. The Acute Physiological Support Team (APST) was created with the twin objectives of identifying high-risk acute surgical patients in the general wards and reducing both the incidence of error and impact of error on these patients. A number of error taxonomies were used to understand the causes of human error and a simple risk stratification system was adopted to identify patients who are particularly at risk of error. ResultsDuring the period November 2012–January 2013 a total of 101 surgical patients were cared for by the APST at Edendale Hospital. The average age was forty years. There were 36 females and 65 males. There were 66 general surgical patients and 35 trauma patients. Fifty-six patients were referred on the day of their admission. The average length of stay in the APST was four days. Eleven patients were haemo-dynamically unstable on presentation and twelve were clinically septic. The reasons for referral were sepsis,4 respiratory distress,3 acute kidney injury AKI (38), post-operative monitoring (39), pancreatitis,3 ICU down-referral,7 hypoxia,5 low GCS,1 coagulopathy.1 The mortality rate was 13%. A total of thirty-six patients experienced 56 errors. A total of 143 interventions were initiated by the APST. These included institution or adjustment of intravenous fluids (101), blood transfusion,12 antibiotics,9 the management of neutropenic sepsis,1 central line insertion,3 optimization of oxygen therapy,7 correction of electrolyte abnormality,8 correction of coagulopathy.2 ConclusionOur intervention combined current taxonomies of error with a simple risk stratification system and is a variant of the defence in depth strategy of error reduction. We effectively identified and corrected a significant number of human errors in high-risk acute surgical patients. This audit has helped understand the common sources of error in the general surgical wards and will inform on-going error reduction initiatives.

Neutropenic sepsis: prevention and management of neutropenic sepsis in cancer patients (NICE Clinical Guideline CG151)

Information about current guideline In September 2012, the National Institute for Clinical Excellence (NICE) published a guideline entitled ‘Neutropenic sepsis: prevention and management of neutropenic sepsis in cancer patients’.1 The...

34 Audit of management of neutropenic sepsis in adults receiving systemic anticancer therapy within Belfast Health and Social Care Trust

34 Audit of management of neutropenic sepsis in adults receiving systemic anticancer therapy within Belfast Health and Social Care Trust

The Febrile Patient with Neutropenia

Fever in a neutropenic patient is an acute medical emergency. This article considers the diagnosis, investigation and management of neutropenic sepsis, along with the clinical challenges that an acute physician may face when treating patients presenting with this condition.

Improving the immediate management of neutropenic sepsis in the UK: lessons from a national audit

Recent disquiet at inadequacies in the immediate management of neutropenic sepsis in the UK led to a new, gold standard 'door-to-needle' time of 1 h for the administration of intravenous antibiotics. The aim of this audit was to identify whether that target is being met nationally, the potential barriers to its achievement, and concrete recommendations for how to overcome these. We also sought to establish the degree of regional heterogeneity in current local management protocols. Questionnaires were sent to haematologists across the UK to determine their unit's immediate management of patients presenting from the community with possible neutropenic sepsis. Local protocols and audits were also requested. Data covering 95 different hospitals were received, covering a combined catchment area of nearly 30 million people. There were marked regional inconsistencies in the definition of 'neutropenic sepsis' and almost every aspect of its immediate management. Only 26% of audited patients (n=627) received intravenous antibiotics within the target time of 1 h. Median door-to-needle times ranged from 30 min to 4 h. Long delays of over 5 h were not uncommon.

Improving management of neutropenic sepsis in the emergency department

Improving management of neutropenic sepsis in the emergency department