Rapid Antibiotic Administration

Implementation of an Evidence-Based Algorithm to Guide the Assessment and Rapid Antibiotic Administration in Pediatric Patients

Project Leader: Janet Smith, BSN RN CPON | Patient Care Nurse Manager

Institution: The University of Texas M.D. Anderson Cancer Center. | Houston, Texas

Grant Type: APHON Evidence-Based Practice Grant

Year Awarded: 2018


The Association of Pediatric Hematology/Oncology Nurses (APHON) describes the role of the pediatric hematology/oncology nurse as applying knowledge derived from research and theory to the care of the pediatric, adolescent, and adult patient. This project aims to integrate existing evidence demonstrating the effectiveness of an algorithm to guide the implementation of rapid antibiotics for pediatric patients presenting with neutropenic fever. Rapid time to antibiotics is often defined clinically as occurring within 1 hour of fever identification. The algorithm supports the rapid yet accurate assessment of and delivery of antibiotics to these patients consistent with the recommended parameters put forth by the Infectious Diseases Society of America and the Children’s Oncology Group. The algorithm provides evidence-based standardized processes to guide pediatric nurses across practice settings and clinical roles in a consistent assessment and management of the febrile neutropenic patient, which may decrease the potential for sepsis and enhance outcomes. The project team will utilize the ARCC (Advancing Research and Clinical practice through close Collaboration) timeline for an EBP implementation project to guide the conduct of this project. The process will include the assembly of interprofessional stakeholders to identify current challenges in the workflow, synthesis of the literature on evidence-based interventions to enhance these workflows, and development, implementation, and evaluation of an algorithm for pediatric patients with febrile neutropenia. Time to antibiotic administration will be the primary outcome measure evaluated to demonstrate improvement. The final algorithm will then be submitted for institutional approval to support sustained implementation across the hospital. This project offers the opportunity for critical appraisal of the evidence, application to practice, and evaluation of outcomes, consistent with the emphasis on scholarly nursing practice put forth by the American Nurses Association and APHON. Such a project supports the ability of pediatric hematology/oncology nurses to provide safe and effective care to patients.