Establishing an outpatient acute care clinic (ACC) decreases the time from fever to antibiotic administration among patients with hematologic malignancies experiencing febrile neutropenia (FN), according to research published in the Clinical Journal of Oncology Nursing.

Researchers developed an ACC embedded in an established infusion center at Duke University Hospital in Durham, North Carolina, in 2020-2021. They compared the management of FN before and after the ACC program launch.

The ACC treatment process was triggered when a patient with a hematologic malignancy contacted the ACC with a fever. The patient was immediately scheduled for infusion and assigned to a registered nurse for management.

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Once the patient arrived at the clinic, they were examined, and intravenous antibiotics were administered. The patient was discharged or admitted to the hospital depending on posttreatment vital signs.

This study included 15 pre-ACC patients and 16 post-ACC patients. The mean ages were 57.44 years and 60.88 years, respectively.

The mean time from fever to antibiotic administration was 144.88 minutes before the ACC was established and 63.69 minutes after (P =.008). Significantly more patients received antibiotics within 1 hour of fever at the ACC (P <.001), and patients were satisfied with the ACC.

“These findings support using a dedicated outpatient ACC for patients with FN receiving hematology care,” the researchers wrote.


Frith J, Allen D, Minor K, Reynolds SS. Febrile neutropenia: Improving care through an oncology acute care clinic. Clin J Oncol Nurs. 2023;27(1):33-39. doi:10.1188/23.CJON.33-39

This article originally appeared on Oncology Nurse Advisor