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Introduction of 24 hour electronic alerts for neutropenic sepsis patients reduces ITU/HDU admissions to 3%
To use a 24 hour emergency alert to advise Newton 5 ward of known chemotherapy patient emergency admissions at Sandwell and West Birmingham Hospitals NHS Trust (SWBH).
To ensure that intravenous antibiotics for neutropenic sepsis are delivered within the one hour door to needle time frame. This will be achieved by streamling the pathway to enable patient flow and reducing or eliminating unnecessary patient waits.
Key areas of achievement:
- Reduction in ITU/HDU admissions from 17% to 3%.
- Average door to needle times reduced from 4 hours to 1 hour 7 minutes with 71% of patients achieving 1 hour goal and maximum wait now 2.5 hours.
- Introduction of the history, examine, action treat (HEAT) campaign to all emergency departments.
- Closer links between oncology, haematology and urgent care shift co-ordinators.
- Early identification of potential neutropenic sepsis patient by urgent care shift co coordinators.
- Production of patient information leaflet on complications of chemotherapy and key worker contact details.
- Inclusion of patients with pre malignant disease who are treated with chemotherapy in the alert process.
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Three day reduction in length of stay through improving the pathway to deliver antibiotics within one hour
Ensure that intravenous antibiotics for neutropenic sepsis is delivered within the one hour door to needle time frame. Spread learning achieved to all acute trusts in the Pan Birmingham Cancer Network to improve current service delivery.
Key areas of acheivement are:
- Clear understanding of patient pathway
- Targeted staff education
- Easy access to electronic copy of protocol
- Patient flag on electronic patient record system
- Development of patient alert card
- Appropriate antibiotics available in high visibility box
- Introduction of patient group directive
- Introduction of UKONS triage system