Table 6 Key areas for improvement and action points for SWLCN

From: A prospective study of chemotherapy-induced febrile neutropenia in the South West London Cancer Network. Interpretation of study results in light of NCAG/NCEPOD findings

Key areas for improvement

 Improve time to antibiotics

 Develop a structured education and monitoring process for high risk patients

 Improve uptake of prophylactic antibiotics for high risk patients

Key actions

 New clinical pathway – streamlined to avoid delays

Within 10 min of presentation

Assessment and observations, blood tests and antibiotics sourced, senior designated person contacted

Within 1 h of presentation

Administration of intravenous antibiotic

Medical assessment

Decision on additional tests and ongoing management

Within 1–2 h of presentation

Ongoing monitoring and review

Within 4 h of presentation

Patients requiring inpatient stay are admitted to hospital

 Development of acute oncology service within each cancer centre

 Development of standardised SWLCN protocol for management of neutropenic sepsis

 Patient information

Reviewed and developed in partnership with patients; for example, the patient alert card to help patients understand when and how to access emergency help and advice

 Education and training package for staff

Implementation of the HEAT (history, examine, action and treat tool; Dikken, 2009). This consists of a poster, patient alert card and DVD outlining symptoms of neutropenic sepsis and required actions

 Ongoing audit

  1. Abbreviations: DVD=digital video disc; SWLCN=South West London Cancer Network.
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