title: Prechemotherapy assessment of neutropenic risk.
abstract: Chemotherapy-induced febrile neutropenia (FN) predisposes patients to life-threatening infections and typically requires hospitalization. The goal was to investigate whether a risk assessment tool aligned with national guidelines could help identify patients at risk of FN and reduce FN-related hospitalizations. Beginning in October 2004, oncology nurses applied the new risk assessment tool to all patients initiating chemotherapy or a new regimen. Patients at risk for FN received prophylactic colony-stimulating factor. Charts for 189 patients receiving chemotherapy in fiscal year 2005 (FY05) were compared with charts of 155 patients receiving chemotherapy in FY04, before the tool was implemented. The incidence of FN-related hospitalization declined by 78%, from 9.7% in FY04 to 2.1% in FY05 (P = .003). Total hospital days decreased from 117 to 24. Routine systematic evaluation by oncology nurses improves recognition of patients at risk of FN and substantially reduces FN-related hospitalization.
authors.affiliation: Puget Sound Veterans Affairs Medical Center, Cancer Care Clinic, Seattle, Washington 98108, USA. Anne.Doyle2@va.gov
authors.forename: Anne M
authors.initials: AM
authors.lastname: Doyle
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects*; D005334:Fever / Q000139:chemically induced* / Q000517:prevention & control; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy / Q000451:nursing*; D009503:Neutropenia / Q000139:chemically induced* / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D018570:Risk Assessment
chemical_list: D000970:Antineoplastic Agents; D016179:Granulocyte Colony-Stimulating Factor