Dissertation
Improving patient experiences and outcomes during febrile neutropenia in pediatric oncology patients when presenting to rural emergency departments
University of Iowa
Doctor of Nursing Practice (DNP), University of Iowa
Spring 2025
Abstract
Background: Fever is one of the most common causes for Emergency Department visits in the pediatric oncology patient population, with one in three patients developing febrile neutropenia at least once during their treatment course. These patients are at an increased risk of developing bacteremia if antibiotics aren t administered within 60 minutes from fever detection. Prompt evaluation during febrile neutropenia work-up has been an ongoing issue at rural facilities, leading to delays in antibiotic administration and a decreased level of patient satisfaction. Purpose: To improve the care and satisfaction of patients and their families who are receiving oncology treatment at a Midwest academic children s hospital when treated for febrile neutropenia at outside Emergency Departments. Methods: This Quality Improvement project utilized the Iowa Model of Evidence-Based Practice as its project design. Surveys were sent out to identify patient experiences and level of satisfaction at previously used facilities and to identify baseline nursing knowledge on febrile neutropenia before receiving education on the topic. Additional surveys were distributed to evaluate for an increase in nursing knowledge, and patient experiences and satisfaction after the education was completed at the pilot site. Findings: Top causes of dissatisfaction for patients included port accessing, delays in time to treatment, and a lack of febrile neutropenia knowledge by their care team. Nursing knowledge improved after receiving education on febrile neutropenia. Patients seen at the pilot site had decreased port accessing attempts, receiving their antibiotics within one hour of arrival, and reported improved levels of satisfaction with their care. Discussion: Improved nursing knowledge on the topic of febrile neutropenia, increased level of satisfaction of patients and their families, and improved patient care was achieved. Project limitations included a short implementation time period, low survey response rates, and a small number of patients seen at the pilot site.
Details
- Title: Subtitle
- Improving patient experiences and outcomes during febrile neutropenia in pediatric oncology patients when presenting to rural emergency departments
- Creators
- Katherine Keeney - University of Iowa
- Contributors
- Jodi Bloxham (Chair) - University of Iowa
- Resource Type
- Dissertation
- Project Type
- Poster
- Degree Awarded
- Doctor of Nursing Practice (DNP), University of Iowa
- Degree in
- Pediatric Nurse Practitioner (Acute Care)
- Date degree season
- Spring 2025
- Publisher
- University of Iowa
- Number of pages
- 1 page
- Copyright
- Copyright 2025 Katherine Keeney
- Language
- English
- Academic Unit
- College of Nursing; Doctor of Nursing Practice Projects
- Record Identifier
- 9984841035002771
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