Emergency department waiting times for patients with cancer with febrile neutropenia: a pilot study

Abstract

Purpose/objectives: To determine the time frame for evaluation and treatment of adult patients with febrile neutropenia in the emergency department (ED).

Design: Prospective, descriptive survey.

Setting: ED in a large, urban, academic health center.

Sample: 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.

Findings: 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.

Implications for nursing: 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.