Dissertation/Thesis Abstract

An Education Initiative to Reduce Emergency Department Visits for Oncology Patients with Febrile Neutropenia
by Richards, Julie, D.N.P., State University of New York at Binghamton, 2020, 90; 27993712
Abstract (Summary)

Background

Febrile Neutropenia (FN) is a condition prevalent among oncology patients receiving chemotherapy, which suppresses the immune system. Febrile Neutropenia (FN) makes patients easily susceptible to infections; therefore, it is one of the primary reasons oncology patients are rushed to the emergency department (ED) when presenting with adverse symptoms. This study offered valuable insight into how to reduce patients’ visits to the ED by educating patients about self-care procedures they can implement to help them avoid visiting the ED. The study utilized a convenience sample of 68 participants who were randomly assigned to two groups: a control group that received the usual standard of care for chemotherapy education and an experimental group that received an additional educational intervention with regards to FN. The level of each patient’s knowledge about self-care of FN was tested before and after the intervention was implemented. The results revealed a significant improvement in knowledge levels following the intervention. Improvements were observed in both groups; however, there was more improvement within the group that received the intervention.

Methods

This study was conducted to provide a better understanding of the lack of knowledge and increase prompt treatment of those oncology patients diagnosed with Febrile Neutropenia (FN). This study offered valuable insight into educating not only emergency department (ED) providers, but also the patient undergoing chemotherapy. More importantly, this study offered insights into patient expectations and best treatment outcomes, thereby preventing oncology patients from an ED admission.

Results

A pre-test and post-test were completed by each chemotherapy patient in the study, aged 18 to 89. The study discovered that the patient population lacked access to a thermometer and demonstrated decreased knowledge and understanding of what was febrile. Application of evidence-based guidelines for an oncology patient undergoing chemotherapy improved not only prompt care within the ED but also patient awareness of signs and symptoms to monitor and triage promptly. In turn, ED admissions showed a declined for six months following the intervention, and overall better patient outcomes were reported.

Conclusion

Oncology management within an outpatient setting is complex and time consuming. Pairing this complexity with living in a rural county, places additional hardships on patients. The implementation of a verbal chemotherapy education increased patient knowledge regarding when to present for care if complications arose. Providing a neutropenic identification card to patients and the NF order set to ED staff lead to a protocol in which evidenced-based guidelines ultimately improved outcomes.

Indexing (document details)
Advisor: Rouhana, Nicole
Commitee: Fitzgerald, Kathleen, Anderson, Kathleen
School: State University of New York at Binghamton
Department: Nursing
School Location: United States -- New York
Source: DAI-B 82/2(E), Dissertation Abstracts International
Source Type: DISSERTATION
Subjects: Oncology
Keywords: Chemotherapy teach, Febrile, Febrile neutropenia, Neutropenia
Publication Number: 27993712
ISBN: 9798662571327
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