title: Management of febrile neutropenia in an acute oncology service.
abstract: BACKGROUND
  Neutropenic fever in patients receiving chemotherapy is a medical emergency and should be treated promptly within 1 h with antibiotics as specified within the 2009 NCAG report on chemotherapy services.
  
  
  OBJECTIVE
  To determine door-to-assessment, door-to-treatment and door-to-investigation intervals for patients with febrile neutropenia who presented to the inpatient Oncology Ward, the outpatient Oncology Day Unit and the Emergency Department in Addenbrooke's Hospital, Cambridge.
  
  
  METHODS
  Retrospective observational audit.
  
  
  METHODS
  Thirty-two patients on treatment for solid cancers who were admitted with febrile neutropenia between January and December 2010 were identified, and paper and electronic medical records were analysed to determine door to: assessment, treatment and investigation intervals.
  
  
  CONCLUSIONS
  Patients in this series were assessed quicker and received the first dose of antibiotics faster when they presented to an oncology ward rather than the emergency department. However, imaging was performed faster and blood results issued quicker if performed in the emergency department due to a better infrastructure that has been tailored to comply with national targets. Nonetheless, compliance with optimum standards of care was poor, with only 9% of sampled patients getting antibiotics within 1 h of presenting to hospital, and 53% within 1 h of being assessed by a clinician.
authors.affiliation: Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge CB2 0QQ, UK. stephen.sammut@nhs.net
authors.forename: S J
authors.initials: SJ
authors.lastname: Sammut
authors.forename: D
authors.initials: D
authors.lastname: Mazhar
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects; D004334:Drug Administration Schedule; D004636:Emergency Service, Hospital / Q000592:standards; D004739:England; D005260:Female; D005334:Fever / Q000139:chemically induced / Q000188:drug therapy*; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy; D009503:Neutropenia / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy*; D016522:Oncology Service, Hospital / Q000592:standards*; D009894:Opportunistic Infections / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy; D017410:Practice Guidelines as Topic; D011787:Quality of Health Care; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000970:Antineoplastic Agents