Febrile Neutropenia: Improving Care Through an Oncology Acute Care Clinic

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BACKGROUND: Patients with cancer are at risk for oncologic emergencies, including febrile neutropenia (FN). Timely treatment of FN can prevent complications. Providing this care in the outpatient setting has been shown to be safe and effective. OBJECTIVES: This project implemented and evaluated a new process using an outpatient acute care clinic (ACC) to manage FN in patients with hematologic cancer. The aims were to reduce the time from fever identification to antibiotic administration, decrease emergency department (ED) visit rates, and evaluate patient satisfaction. METHODS: Using a pre-/postimplementation design, an interprofessional team was educated about a new process of caring for patients with hematologic cancer and FN at an outpatient ACC using a comprehensive algorithm. FINDINGS: 31 patients participated in the project (15 pre-and 16 postimplementation). Time to antibiotic administration decreased from 144.88 minutes to 63.69 minutes. Participant visits to the ED decreased by 2.33 times per month on average. Overall, patients were satisfied with the ACC. These findings support using a dedicated outpatient ACC for patients with FN receiving hematology care.






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Frith, Jennifer, Deborah Hutch Allen, Kerry Minor and Staci S Reynolds (2023). Febrile Neutropenia: Improving Care Through an Oncology Acute Care Clinic. Clinical Journal of Oncology Nursing, 27(1). pp. 33–39. 10.1188/23.CJON.33-39 Retrieved from https://hdl.handle.net/10161/26912.

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Staci Reynolds

Clinical Professor in the School of Nursing

Dr. Staci Reynolds joined Duke in January 2016, with a joint position between Duke University School of Nursing and Duke University Hospital (DUH).  At DUSON, Dr. Reynolds teaches in the ABSN Program (neuroscience nursing) and DNP program (healthcare quality improvement methods).  Clinically, she served as a neuroscience Clinical Nurse Specialist (CNS) for the inpatient neuro units at DUH from 2016 - 2019 and for the Infection Prevention and Hospital Epidemiology department from 2019 - 2023. Dr. Reynolds coordinated the Duke Advancement of Nursing, Center of Excellence (DANCE) academic-practice partnership from 2016 - 2023, and was the faculty lead for the post-DNP Quality Implementation Scholars Program from 2019 - 2022.  In January 2023, Dr. Reynolds was appointed the Editor-in-Chief of the Journal of Nursing Care Quality.  Before coming to DUSON, she was a neuro critical care nurse and a neuroscience Clinical Nurse Specialist at Indiana University Health Methodist Hospital.

Dr. Reynolds received a baccalaureate degree in nursing science from Indiana University (IU) in Indianapolis, Indiana.  She earned a Master’s degree as a Clinical Nurse Specialist at IU in 2011, and completed her PhD at IU in May 2016.  Dr. Reynolds’ dissertation focused on implementation of clinical practice guidelines, and her current research interests includes evidence-based practice implementation and quality improvement.

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