A clinical decision aid helped standardize the management of patients with febrile neutropenia, a single-institution study showed. The findings were recently published in the Journal of Oncology Practice.1
The study researchers developed a clinical decision aid for the management of febrile neutropenia at Mayo Clinic, and the purpose of the tool was to help clinicians determine the appropriate diagnostic tests and antimicrobial therapy for patients with febrile neutropenia within the first 24 hours.
The incidence of febrile neutropenia was assessed at baseline, during, and after implementation of the clinical decision aid. At baseline, a total of 28 patients were suspected for febrile neutropenia, 14 of which were confirmed. During implementation of the tool, 26 patients were suspected for febrile neutropenia, 11 of which were confirmed. After implementation of the tool, 32 patients were suspected for febrile neutropenia, 15 of which were confirmed.
At baseline, 42.9% patients received antimicrobial therapy that adhered to best practice; adherence increased to 72.7% during implementation and 66.6% after implementation (P=0.19). At baseline, 50% of patients underwent radiologic studies that adhered to best practice; adherence increased to 100% during implementation and remained at 100% after implementation (P<0.01). At baseline, 21.4% patients received laboratory studies that adhered to best practice; adherence increased to 54.6% during implementation and 86.7% after implementation (P<0.01).
Overall, 71% of patients had a critical deviation at baseline, whereas 27.3% of patients during implementation and 33.3% after implementation had a critical deviation (P=0.04).
“A clinical decision aid can improve adherence to best practices for the empirical management of FN [febrile neutropenia],” the study authors wrote.
- O’Horo JC, Marcelin JR, Abu Saleh OM, et al. Standardizing febrile neutropenia management: antimicrobial stewardship in the hematologic malignancy population [published online July 19, 2019]. J Oncol Pract. doi: 10.1200/JOP.18.00775