Decreasing Hospital Observation Time for Febrile Infants

• DOI: 10.12788/jhm.3593
• Publication Date: 2021-05-07T13:28:58Z
• Authors: Sanyukta Desai; Tara Calhoun; Tina Sosa; Joshua D Courter; Alexandra Letsinger; Matthew Le; Amy Schubert; Lindsay Zaremba; Samir S Shah; Karen Jerardi; Angela M Statile; Ndidi I Unaka
• Keywords: Guideline

BACKGROUND Febrile infants aged 0 to 60 days are often hospitalized for a 36‐to‐48 hour observation period rule out invasive bacterial infections (IBI). Evidence suggests that monitoring blood and cerebrospinal fluid (CSF) cultures 24 hours may be appropriate most infants. We aimed decrease the average culture time (COT) from 38 30 among old over 12 months. METHODS This quality improvement initiative occurred at large children's hospital, in conjunction with development of multidisciplinary evidence‐based guideline management febrile included admitted fever without clear infectious source. excluded who had positive blood, urine, or CSF within incubation were other indications (eg, bronchiolitis). Interventions dissemination, education regarding laboratory practices, standardized order sets, near‐time identification failures. Our primary outcome was COT, defined as between initiation hospital discharge hours. tracked on an annotated statistical process control chart. balancing measure IBI after discharge. RESULTS In our cohort 184 days, COT decreased 32 structured dissemination order‐set standardization; this sustained 17 not identified any patients CONCLUSIONS Implementation through education, transparency procedures, creation feedback associated shorter days.