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Show NEUTROPENIC PRECAUTION PROTOCOL AT PRIMARY CHILDREN'S HOSPITAL Kyrsten Anderson, University of Utah BSN Student Intervention Background v Neutropenic pediatric patients have many reasons they need to adhere to neutropenic precautions. v However, the current neutropenic precaution protocol at Primary Children's Hospital contains elements that are not evidence-based, leaving patients and families isolated for longer than recommended and imposing precautions that can lead to a decreased quality of life. v This project discusses the impact of an updated neutropenic protocol on patient satisfaction scores over a period of 3-months. PICOT Question v In nurses working with neutropenic pediatric patients on ICS at Primary Children's Hospital, what is the impact of an updated neutropenic precaution protocol for patients/families compared to the current neutropenic protocol on patient satisfaction scores over a 3-month period? PRIMARY CHILDREN'S NEUTROPENIC PROTOCOL IN ORDER OF EFFECTIVENESS BASED ON CURRENT 1,2 EVIDENCE-BASED PRACTICE EFFECTIVE PRACTICES: v Hand hygiene v Antibiotic/antifungal/antiviral prophylaxis v Colony-stimulating factors v Anti-fungal oral care v Central line care v General infection control recommendations v Patient should wear a mask outside of hospital room LIKELY TO BE EFFECTIVE: v CHG baths BENEFICIAL WITH KNOWN HARMS: v IV immunoglobin EFFECTIVENESS NOT ESTABLISHED: v Protective isolation v Low microbial diet/restriction of fresh fruits and vegetables v Update the current protocol to better reflect evidence-based practices. v Take out the low-microbial diet restrictions to help maintain adequate nutrition.3 v Use child-friendly isolation signs and provide developmentally appropriate education about the isolation to improve compliance and lower 4 distress. v Include options of what patients can do in isolation/create a community among patients (e.g. by playing video games as a unit).4 Implementation v Implementation of this updated protocol will include: v Education of staff (e.g. nurses, providers, techs) v Education of patients/families through updating the admission and other educational handouts v Patient satisfaction scores will be measured over a period of 3-months. References 1. Mize, L., Harris, N., Stokhuyzen, A., Avery, T., Cash, J., Kasse, M., Sanborn, C., Leonardelli, A., Rodgers, C., & Hockenberry, M. (2014). Neutropenia precautions for children receiving chemotherapy or stem cell transplantation for cancer. Journal of Pediatric Oncology Nursing, 31(4), 200-210. 2. Wilson, B., Zitella, L. J., Erb, C. H., Foster, J., Peterson, M. & Wood, S. K. Prevention of infection: A systematic review of evidence-based practice interventions for management in patients with cancer. Clinical Journal of Oncology Nursing, 22(2), 157-168. 3. Linder, L. A., & Seitz, M. (2017). Through their words: Sources of bother for hospitalized children and adolescents with cancer. Journal of Pediatric Oncology Nursing, 34(1), 51-64. 4. Alvarez, E. N., Pike, M. C., & Godwin, H. (2020). Children's and parent's views on hospital contact isolation: A qualitative study to highlight children's perspectives. Clinical Child Psychology and Psychiatry, 25(2), 401-418. COLLEGE OF NURSING |
