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A multimodal strategy to improve health care for pediatric patients with cancer and fever in Peru.

Authors :
Mendieta, Ana
Lopez, Ligia Rios
Arteaga, Maria Vargas
Maradiegue, Essy
Arone, Walter Delgadillo
Bazalar, Carlos Rueda
Holguin, Alexis
Salas, Carlos Santillan
Maza, Ivan
Homsi, Maysam
Barrios, Frankly Farias
Assayag, Claudia
Vásquez, Liliana
Pascual, Claudia
Caniza, Miguela
Source :
Pan American Journal of Public Health. 2023, Vol. 47, p1-10. 10p.
Publication Year :
2023

Abstract

Objective. The DoTT (Decreasing Time to Therapy) project aimed to minimize the interval between fever onset and medical interventions for children with febrile neutropenia. The objective of this study was to determine the effect of implementing the DoTT project on the hospital time to antibiotic (TTA) and patient time to arrival (PTA) at the hospital in children with febrile neutropenia admitted to the emergency department. Methods. The DoTT project was implemented at a Peruvian hospital and followed the World Health Organization (WHO) multimodal improvement strategy model. Components included creating a healthcare delivery bundle and antibiotic selection pathways, training users of the bundle and pathways, monitoring patient outcomes and obtaining user feedback, encouraging use of the new system, and promoting the integration of DoTT into the institutional culture. Emergency room providers were trained in the care delivery for children with cancer and fever and taught to use the bundle and pathways. DoTT was promoted via pamphlets and posters, with a view to institutionalizing the concept and disseminating it to other hospital services. Results. Admission data for 129 eligible patients in our registry were analyzed. The TTA and PTA were compared before and after the DoTT intervention. The median TTA was 146 minutes (interquartile range [IQR] 97--265 minutes) before the intervention in 99 patients, and 69 minutes (IQR 50--120 minutes) afterwards in 30 patients (p < 0.01). The median PTA was reduced from 1 483 minutes at baseline to 660 minutes after the intervention (p < 0.01). Conclusions. Applying the WHO multimodal improvement strategy model to the care of children with febrile neutropenia arriving at the hospital had a positive impact on the PTA and TTA, thus potentially increasing the survival of these patients. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
10204989
Volume :
47
Database :
Academic Search Index
Journal :
Pan American Journal of Public Health
Publication Type :
Academic Journal
Accession number :
174630227
Full Text :
https://doi.org/10.26633/RPSP.2023.140