Search

BACKGROUND: Intravenous (IV) fluid shortages have become more prevalent since the 2017 destruction of one of the major manufacturers of IV fluid bags in Puerto Rico. Complications in adjusting IV antibiotic orders within the hospital setting may lead to a significant delay in the delivery of antibiotics to patients with febrile neutropenia. OBJECTIVE: To evaluate the impact of IV fluid shortages on the delivery of antibiotics to patients with febrile neutropenia. METHODS: As part of a continuing quality improvement audit, we completed 2 retrospective audits to assess antibiotic drug delivery times before and after the IV fluid shortage. In November 2017 and May 2018, patients admitted to Avera McKennan Hospital and University Health Center with febrile neutropenia were evaluated for successful 60-minute antibiotic administration. Febrile neutropenia was defined by local institutional protocols concerning absolute neutrophil count and temperature values. We collected data in a retrospective chart review and completed a statistical analysis using a Fisher's exact test. RESULTS: The 2 audits (conducted before and after the fluid shortage) revealed time to administration success rates of 93.75% (15 of 16 patients) and 33.33% (7 of 21 patients) for the preshortage and postshortage audits, respectively. The 60.42% difference between the 2 rates of time to antibiotic administration was statistically significant (P = .0002). CONCLUSION: Our findings suggest that IV fluid shortages led to a significant delay in time to antibiotic administration, a known risk for mortality, in the treatment of patients with febrile neutropenia. [ABSTRACT FROM AUTHOR]