title: Emergency department waiting times for patients with cancer with febrile neutropenia: a pilot study.
abstract: OBJECTIVE
  To determine the time frame for evaluation and treatment of adult patients with febrile neutropenia in the emergency department (ED).
  
  
  METHODS
  Prospective, descriptive survey.
  
  
  METHODS
  ED in a large, urban, academic health center.
  
  
  METHODS
  19 patients with febrile neutropenia during 23 ED visits in eight months.
  
  
  METHODS
  Demographic and treatment variables and durations of time were recorded from ED and medical records.
  
  
  RESULTS
  Patients had fevers a mean of 21 hours (range = 1-72 hours) before seeking treatment. Median waiting time from ED admission to examination was 75 minutes, 210 minutes before antibiotics were given, and 5.5 hours to hospital admission. Patients with more comorbidities and more extensive cancer waited significantly longer than those at lower risk (p less than 0.002).
  
  
  CONCLUSIONS
  Although the standard of care is to treat febrile neutropenia as an oncologic emergency, patients waited prolonged periods prior to receiving treatment. Studies are indicated to examine early intervention for febrile neutropenia and to determine whether early intervention improves clinical outcomes.
  
  
  CONCLUSIONS
  Nurses may repeat this study at other settings and with other populations of people with cancer. Other studies may provide evidence that clinical outcomes are dependent on rapid intervention for febrile neutropenia in the cancer population or evaluate the efficacy of education that oncology nurses deliver to people with cancer and febrile neutropenia.
authors.affiliation: School of Nursing, Columbia University in New York, NY, USA. an207@columbia.edu
authors.forename: Anita
authors.initials: A
authors.lastname: Nirenberg
authors.forename: Lisa
authors.initials: L
authors.lastname: Mulhearn
authors.forename: Susan
authors.initials: S
authors.lastname: Lin
authors.forename: Elaine
authors.initials: E
authors.lastname: Larson
mesh_terms: D000046:Academic Medical Centers / Q000706:statistics & numerical data*; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015897:Comorbidity; D042241:Early Diagnosis; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005334:Fever / Q000453:epidemiology / Q000209:etiology*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D016867:Immunocompromised Host; D007239:Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000453:epidemiology / Q000276:immunology; D009503:Neutropenia / Q000453:epidemiology / Q000209:etiology*; D009519:New York City / Q000453:epidemiology; D010343:Patient Admission / Q000706:statistics & numerical data; D011446:Prospective Studies; D012306:Risk; D018805:Sepsis / Q000517:prevention & control; D013997:Time Factors; D014218:Triage
chemical_list: D000900:Anti-Bacterial Agents