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• W3217414462 abstract "Background Paediatric oncology patients with fever and suspected neutropenia are at risk of developing life-threatening systemic infection. Prompt Emergency Department assessment, early intervention and antibiotic administration within 60 minutes of hospital presentation is now recognised as the required standard of care. Nurse-initiated protocols have been implemented in emergency departments to facilitate timely care for a variety of patient groups, yet little is known about their feasibility in this population. Aim To provide an overview of the existing evidence regarding nurse-initiated protocols in the emergency management of paediatric oncology patients with fever and suspected neutropenia. Methods This scoping review followed the JBI methodological guidance for conducting scoping reviews. Comprehensive, systematic searches were conducted in Embase, Medline (Ovid), Scopus, Emcare (Ovid), CINAHL Plus, Google Scholar, Open Grey, and Theses Global. Findings Of the 768 studies imported for screening, 504 were excluded at title and abstract screening, and 39 studies were assessed for eligibility at full-text screening. Fourteen studies met the inclusion criteria and were included for review. Important findings included the identification of; sources of delay in care, the key features of nurse-initiated protocols, and the outcomes, barriers and facilitators of the protocols. Through the effective streamlining of care provision, communication, and increased nursing autonomy via nurse-initiated protocols, improvements in time to care initiation, investigations and antibiotic delivery was demonstrated. Barriers are related to insufficient nursing staff knowledge, technical skill, parental opposition and institutional inexperience in protocol initiation. With appropriate institutional support, multidisciplinary involvement, family engagement and ongoing education the successful implementation of nurse-initiated protocols was facilitated. Discussion/Conclusion The available evidence is limited to primary quality improvement projects. Further high quality research is required before definitive recommendations for practice can be made, however, evidence suggests that nurse-initiated protocols may be an effective strategy to improve the emergency department care of paediatric oncology patients presenting with fever and suspected neutropenia." @default.
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• W3217414462 date "2021-11-01" @default.
• W3217414462 modified "2023-09-27" @default.
• W3217414462 title "Emergency department nurse-initiated protocols for paediatric febrile neutropenia: A scoping review" @default.
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• W3217414462 doi "https://doi.org/10.1016/j.colegn.2021.10.015" @default.
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