Australia’s first paediatric low-risk Febrile Neutropenia program

Last year the RCH became the first hospital in Australia to implement a paediatric low-risk Febrile Neutropenia program

Last year the RCH became the first hospital in Australia to implement a paediatric low-risk Febrile Neutropenia program.

Febrile Neutropenia (FN) means a child has a fever higher than 38°C and low neutrophils, which is a type of white blood cell important for fighting infections. It’s one of the most common complications when treating childhood cancer and a leading cause of unplanned hospital admissions for oncology patients.

The low-risk FN program assists staff in identifying children with FN who are at low risk of infection or medical complications. It provides a pathway for them to be safely cared for in their own home, with support from Hospital in the Home.

The low-risk FN program has been informed from results of the Australian PICNICC study, a national paediatric FN study led by Peter MacCallum Cancer Centre and the RCH.

Children on the program are visited daily by Wallaby staff for antibiotics and blood samples to monitor their neutrophils. Wallaby staff work with the patient’s treating team to deliver care until their neutrophil count has increased to an acceptable level.

Before the program was introduced, children with low risk FN were admitted to the RCH for up to four days. Now suitable patients are transferred to Wallaby within 24 hours.

“Program implementation has been a collaboration between the Paediatric Integrated Cancer Service (PICS), Children’s Cancer Centre, HITH, the Emergency Department and the Infectious Diseases and Pharmacy teams, with all teams sharing a common goal to provide a better experience to our patients and families,” RCH Consultant and the program’s lead investigator, Dr Gabrielle Haeusler, said.

“The teams involved recently transferred the 50th patient to the program, which is a wonderful achievement.”

While the program is undergoing formal economic and quality of life evaluation, many benefits are already apparent.

“Over the past year we have been able to reduce the average length of in-hospital stay from four days to one day, saving 230 in-hospital bed days and improving access and flow,” Gab said.

“Even more important is the improved quality of life for the patients and their families – treating a child in their own environment means less disruption to their daily routine and can reduce anxiety and stress.”

The program is now becoming business-as-usual at the RCH and the teams involved are looking for ways to support other hospitals in Victoria, and across Australia, to implement a similar program.

The low-risk FN program is supported by Better Care Victoria and PICS.

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