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The question has been raised. Is it best practice to reverse barrier
nurse febrile neutropenic patients or not?Staff have suggested that maybe patients are not getting the best care
by being isolated as the patients feel neglected and shut off, our
Oncologists feels that once antibiotics are commenced that there is no
need to isolate, “standard precautions” is all that’s needed.I’m interested, what is the current practice out there?
Regards Lyn
Lyn Golden
17 Francis Street
Echuca 3564
P 54855340
Helping Everyone To Be And Stay Healthy
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Dear Lyn,
At our facility, we do not reverse barrier nurse (or protective isolation) patients who are neutropenic. But we do have certain measures such as we try to allocate them a bed in a two bedded bay and preferably next to a person who might have come for a straightforward reason to hospital such as an elective surgery and has no comorbidities, etc.
Rita
Rita RoyClinical Nurse Consultant | Infection Control
Hornsby Ku ring gai Health Service, Palmerston Road, Hornsby NSW 2077
Tel (02) 9477 9232 | Fax (02) 9477 9013 | Mob 0422 930 370 | Rita.Roy@health.nsw.gov.au
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The question has been raised. Is it best practice to reverse barrier nurse febrile neutropenic patients or not?
Staff have suggested that maybe patients are not getting the best care by being isolated as the patients feel neglected and shut off, our Oncologists feels that once antibiotics are commenced that there is no need to isolate, “standard precautions” is all that’s needed.
I’m interested, what is the current practice out there?
Regards LynLyn Golden
17 Francis Street
Echuca 3564
P 54855340
E lgolden@erh.org.au[ERH Logo – Abbreviated – CMYK]
Helping Everyone To Be And Stay HealthyEchuca Regional Health does not guarantee that this e-mail is virus or error free. The attached files are provided and may only be used on the basis that the user assumes all responsibility for any loss, damage or consequence resulting directly or indirectly from the use of the attached files, whether caused by the negligence of the sender or not. The content and opinions in this e-mail are not necessarily those of Echuca Regional Health.
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Hi Lyn,
In our oncology ward we do use “neutropenic precautions” to reverse barrier nurse these patients , but only if their neutrophil count is less than 1.0. The Oncology NUM oversees all of this.
We leave it to the discretion of the senior nursing staff on the ward and the patients Dr in conjunction with the patient to balance their need for visitors and family whilst protecting the patient from potential infection. This may include the use of masks by significant others (if they are unwell) or no PPE at all for visitors or reduced visitors until the patients neutrophil count improves. All visitors are encouraged to perform hand hygiene on entry and exit to the room.
Kind regards,
Fiona De Sousa
Infection Prevention & Control Coordinator
Sydney Adventist Hospital
Fiona.Desousa@sah.org.au
185 Fox Valley Road, Wahroonga, NSW, 2076The question has been raised. Is it best practice to reverse barrier nurse febrile neutropenic patients or not?
Staff have suggested that maybe patients are not getting the best care by being isolated as the patients feel neglected and shut off, our Oncologists feels that once antibiotics are commenced that there is no need to isolate, “standard precautions” is all that’s needed.
I’m interested, what is the current practice out there?
Regards LynLyn Golden
17 Francis Street
Echuca 3564
P 54855340
E lgolden@erh.org.au[ERH Logo – Abbreviated – CMYK]
Helping Everyone To Be And Stay HealthyEchuca Regional Health does not guarantee that this e-mail is virus or error free. The attached files are provided and may only be used on the basis that the user assumes all responsibility for any loss, damage or consequence resulting directly or indirectly from the use of the attached files, whether caused by the negligence of the sender or not. The content and opinions in this e-mail are not necessarily those of Echuca Regional Health.
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Hi Lyn
We no longer use ‘neutropenic precautions’ for any patient with neutropenia. The rationale for this is that they are more at risk from infection with commensals and their own flora than from others. We do place them in single rooms, and we do advise visitors who have infections not to visit, but no actual extra PPE (apart from what is needed for Standard Precautions of for cytotoxic therapy). We also try to roster staff who care for neutropenic patients to not also care for patients with overt infections during the same shift, where possible.
We have not seen a rise in neutropenic fever or associated infections in this patient group since implementing this strategy.
Cheers
MichaelMichael Wishart
Infection Control Coordinator
Holy Spirit Northside Private Hospital
627 Rode Road, Chermside, Qld 4032
t: (07) 3326 3068 | f: (07) 3607 2226
e: Michael.Wishart@svha.org.au
w:www.holyspiritnorthside.org.au
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The question has been raised. Is it best practice to reverse barrier nurse febrile neutropenic patients or not?
Staff have suggested that maybe patients are not getting the best care by being isolated as the patients feel neglected and shut off, our Oncologists feels that once antibiotics are commenced that there is no need to isolate, “standard precautions” is all that’s needed.
I’m interested, what is the current practice out there?
Regards LynLyn Golden
17 Francis Street
Echuca 3564
P 54855340
E lgolden@erh.org.au[ERH Logo – Abbreviated – CMYK]
Helping Everyone To Be And Stay HealthyEchuca Regional Health does not guarantee that this e-mail is virus or error free. The attached files are provided and may only be used on the basis that the user assumes all responsibility for any loss, damage or consequence resulting directly or indirectly from the use of the attached files, whether caused by the negligence of the sender or not. The content and opinions in this e-mail are not necessarily those of Echuca Regional Health.
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