| Title |
Blacker, Marie_DNP_2021 |
| Alternative Title |
Implementation of a Clinical Pathway for Outpatient Management of Oncological Neutropenic Fever |
| Creator |
Blacker, Marie L. MSN, APRN, NP-C |
| Collection Name |
Doctor of Nursing Practice (DNP) |
| Description |
The following Doctor of Nursing Practice dissertation examines outpatient management of neutropenic fever in oncology patients at Huntsman Cancer Institute in Salt Lake City, Utah. |
| Abstract |
Febrile neutropenia occurs in approximately 21% of patients receiving chemotherapy for metastatic solid tumors. Oncology patients with neutropenic fever and low risk for complications can be effectively treated in the home. The purpose of this Doctor of Nursing Practice (DNP) project was to develop and implement an evidence-based clinical pathway for the outpatient management of neutropenic fever in oncology patients at Huntsman Cancer Institute in Salt Lake City, Utah. The Multinational Association of Supportive Care in Cancer (MASCC) risk-stratification tool and guidelines from the American Society of Clinical Oncology (ASCO) were used to develop a clinical pathway and decision tree flowchart to care for oncology patients with neutropenic fever in the home. This pathway outlined high quality, cost-effective in-home treatment and established a five-day "Acute Watch" to reduce hospitalizations. Five patients developed symptoms of acute illness and were placed on "Acute Watch." Four were successfully managed at home and avoided hospitalization. Seven nurse practitioners (NPs) and five registered nurses (RNs) were surveyed and rated the clinical pathway 9.3 on a scale of 1-10 for being clinically useful in outlining the assessment, treatment, and follow-up of febrile patients in the home. Oncology patients with neutropenic fever and low risk for complications can be effectively treated in the home by nurse practitioners. The MASCC risk-assessment tool can identify patients at low risk for complications and ASCO guidelines can be adapted to manage oncology patients at home who develop neutropenic fever. Implementation of a five-day Acute Watch program can effectively reduce hospitalizations in patient with acute illness. |
| Subject |
Nursing; Oncology; Nurse practitioners |
| Keywords |
neutropenia; neutropenic fever; febrile neutropenia; fever; outpatient; ambulatory care; home care; hospice; cancer; oncology; symptom management; infection; nurse practitioners |
| Digital Publisher |
Stewart Library, Weber State University, Ogden, Utah, United States of America |
| Date |
2021 |
| Medium |
Dissertation |
| Type |
Text |
| Access Extent |
1.08 MB; 51 page PDF |
| Language |
eng |
| Rights |
The author has granted Weber State University Archives a limited, non-exclusive, royalty-free license to reproduce his or her theses, in whole or in part, in electronic or paper form and to make it available to the general public at no charge. The author retains all other rights. |
| Source |
University Archives Electronic Records; Annie Taylor Dee School of Nursing. Stewart Library, Weber State University |
| Format |
application/pdf |
| ARK |
ark:/87278/s6mgee15 |
| Setname |
wsu_atdson |
| ID |
12072 |
| Reference URL |
https://digital.weber.edu/ark:/87278/s6mgee15 |
