Reply To: Door to antibiotic times

  • Vicki Schaefers

    June 13, 2014 at 3:29 pm

    We have recently revamped our process and last month average time to antibiotic from door was 40.7 min.  95% of our patients got their antibiotic within 60 minutes.

    Sketch of our process
    1)  Patient with fever calls provider and provider sends patient to ED
    2)  Provider calls physician access, they create a pre-reg account (color coded as urgent) and transfer provider to ED MD
    3)  Provider puts in Onc ED Fever (labs, antibiotics – Cefepime as front line) orders on their prereg account and initiates the orders
    4)  Patient presents to ED and gets triaged rapidly due to the color of their pre-reg , gets cx, cbc, antibiotics
    5)  ED provider sees them and adds antibiotics/orders based on exam and counts.

    We tell families that they are not allowed to ask to wait for emla cream if they have not applied it at home.  We did trial this process with the ED MD entering the orders on the pre-reg account, but the ED MD often got pulled in another direction so the Onc on-call providers do it from home.  The ED MD will do it if we are not in the vicinity of our computer while we are on call.
    Vicki Schaefers
    Children’s Hospital & Clinics of MN
    Burnsville, MN
    United States

    Original Message:
    Sent: 04-30-2014 01:09 AM
    From: Sarah Ferrari
    Subject: Door to antibiotic times

    We are revamping our ED protocols for F&N and are curious as to what other institutions have for their door to antibiotic times. Several questions:

    1. What is your average time for door to antibiotics?
    2. Is your ED a stand alone pediatric ED or is it combined adult and Peds?
    3. Have you recently made changes to improve that time, if so how?
    4. What antibiotic is used in the ED for first antibiotic?
    5. Does your ED administer the second dose, if so, what antibiotic is used?
    6. If willing, could you share your ED protocol?


    Sarah Ferrari
    CNS Hem/Onc/SCT
    Redwood City, CA
    United States

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