Emergency department waiting times for patients with cancer with febrile neutropenia: a pilot study.
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.
Nirenberg
Anita
A
School of Nursing, Columbia University in New York, NY, USA. an207@columbia.edu
Mulhearn
Lisa
L
Lin
Susan
S
Larson
Elaine
E
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
D000900:Anti-Bacterial Agents