P380 Time to antibiotics in paediatric febrile neutropenia – experience of a regional unit. (June 2019)

• Record Type: Journal Article
• Authors: Armstrong, Sean; Farombi, Ireti
• Is Part Of: Archives of disease in childhood. Volume 104:(2019)Supplement 3
• Page Start: A308
• Page End: A308
• Publication Date: 2019-06
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2019-epa.726
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Aim: The aim of this study was to identify the mean Time To Antibiotics (TTA) for children with cancer who present with Febrile Neutropenia to a regional paediatric unit, and explore the barriers to achieving a TTA <60 minutes. Research has shown an increase in mortality and adverse outcomes when delays occur(M, 2013). Methods: All eligible children admitted with Febrile Neutropenia between 1 st January 2016 and 31 st March 2017 were identified. Both the median and logarithmic mean times to clinical assessment, investigation and TTA were calculated using MedCalc. Medical staff completed a survey to identify barriers to achieving the TTA. Results: Ten children were admitted with febrile neutropenia during the timeframe of the study. Three children did not have their arrival time recorded, therefore were excluded (N=7). All were successfully treated. The mean time to phlebotomy was 35 minutes (median 25; range 5–135). The mean time to clinical assessment was 72 minutes from arrival (median 60; range 10–135 mins), and mean time to peripheral culture was 77 minutes (median 70; range 20–155). Our primary outcome, Time to Antibiotics, was calculated as a mean of 144 mins (median 135; range 60–225). 20 medical staff members were surveyed. 19/20 (95%) agreed that Febrile Neutropenia was a medical emergency. 17/20 (85%) correctly identified the target of Time To Antibiotics (TTA) as <60 minutes. Respondents identified workload and lab turnaround times as factors adversely affecting the TTA. Conclusion: A TTA of <60 minutes can be difficult to achieve. These results suggest an opportunity to improve the timeliness of clinical assessment and peripheral culture. The views of nursing staff and parents would provide further insight. This study is limited by the small sample size and lack of standard data recording – specifically related to timing of task completion. References: M, F. (2013). Prompt administration of antibiotics is associated with improved outcomes in febrile neutropenia in children with cancer. Pediatric Blood & Cancer, 60(8), 1299–306.