Improving door-to-needle time for antibiotic treatment of neutropenic sepsis: a quality improvement project

Neutropenic sepsis is a serious, potentially fatal complication of systemic anticancer therapy. Patients with suspected neutropenic sepsis require treatment with intravenous antibiotics within one hour of presentation to hospital. However, national and local audits suggest that this door-to-needle time target is not always met. This article details a quality improvement project (QIP) undertaken in a medical assessment unit (MAU) that aimed to increase the percentage of patients with suspected neutropenic sepsis receiving antibiotics within the one hour door-to-needle time target by 25%. The QIP comprised several components, including audit of door-to-needle times, staff training and a series of improvement initiatives. The results of the audit showed that 60% ( n =30/50) of patients received antibiotics within one hour of presentation to the MAU, an increase of 30% compared with baseline audit data. Although the QIP did not achieve universal adherence to the target door-to-needle time, there was significant improvement which demonstrates that small changes can enhance patient care.