[Impact of the implementation of an early identification tool in the Emergency Department for pediatric oncology patients with febrile neutropenia].

INTRODUCTION AND

OBJECTIVES

Pediatric oncology patients are at high risk for infectious complications, with febrile neutropenia being the most frequent oncological emergency. Early administration of antibiotics, ideally within the first hour of arrival at the emergency department, is associated with improved clinical outcomes. A digital alert tool was implemented to immediately identify these patients through an icon visible to all healthcare and administrative staff. The main objective of the study was to evaluate the impact of this intervention on medical care and antibiotic administration times.

METHODS

A retrospective quasi-experimental study with a before-after design was conducted in the pediatric emergency department of a tertiary hospital between January 2020 and December 2024. Clinical care timelines in patients with febrile neutropenia were compared before (2020-2022) and after (2023-2024) the implementation of the alert tool. Clinical variables, time to medical evaluation, and time to antibiotic administration were collected.

RESULTS

A total of 159 episodes in 104 patients were analyzed. Following the implementation of the alert, the percentage of patients classified as level 2 at triage significantly increased (p=0.001). Time to medical evaluation decreased (median from 25 to 13minutes; p <0.001), as did the time to antibiotic administration (median from 166 to 53minutes; p <0.001). The percentage of patients receiving antibiotics within the first hour increased from 8.3% to 58.7% (p <0.001). No deaths were recorded.

CONCLUSION

The implementation of a digital alert tool improved triage prioritization and significantly reduced the time to medical evaluation and antibiotic administration, enhancing the quality of care for pediatric patients with febrile neutropenia.