I have 8 years of Onco/BMT/HIV experience and am a certified Onco nurse.
Policies vary from hospital to hospital.
However, you need to have the white count differential to determine actual degree of neutropenia. The white count is not sufficient. Most places start minimal neutropenia precautions at ANC<1500, but are much stricter with ANC<500. As your patient has a WBC 1.4, even if the granulcytes were 100% (which they probably are not), the ANC will not be above 1400.
In virtually all facilities that I have worked in, exercise several times per day was encouraged if not mandatory, to prevent DVT's, GI distress and life threatening respiratory infection. The only absolute contraindication would be a platelet count less than 10-15, due to risk of spontaneous bleeds. ALL nontransplant patients were required to ambulate in the hall with gloves, slippers and a mask on. They were also encouraged to take a daily shower with their IV access covered. I, however, have had few patients with a epidural that were not bed ridden so I cannot speak to that issue. But I would think that the epideral could be covered more adequately than IV ports and central lines, and those patients were showering daily. And many of my patients have virtually no registerable ANC whatsoever (WBC <0.2 and 0 Neutrophils.
I am surprised about the epideral. Most of my physicians are reluctant to place an epideral in a pt that has the potential for an extremely low platelet count or other clotting problems. Onco patients have higher risk also of DIC, or DVTs requiring anticoagulation, commonly contraindicating epiderals, due to hemmorhage risk. But as the epideral line is generally accessed less than the IV, I do not believe that it is as much of an infection risk, comparatively speaking.
Other precautions: No fresh salads, no fresh fruit that cannot be peeled (must be peeled), no fresh flowers from garden (most reputable florists get theirs through "clean" regulated sources, theoretically), and no plants with soil (though, again, most florists get "sterilized" soil). In many areas, bottled water of reputable quality is used rather than tap - and definitely warn against use of well water at home. Ice can be a problem - if there is a frig in the room, I freeze a bottle of water and put it out to melt at night, so that they have cold water through the night. Do not use straws (can grow bacteria) and change disposable cups frequently. No children on floor (NO CHILDREN ON FLOOR!!!!). All healthcare workers and visitors wash hands with betadine or hibeclens coming into room and leaving. Those that are sick do not enter, those that have allergies, have to wear a mask.
Allo transplant rules are stricter, and they do not leave the room, but they still shower with hibeclens daily and they have a exercycle in the room that they are required to use daily, barring platelets less than 10-15.
While we worry about the germs in the air, my personal observations (especially with the chemo for "liquid" tumors - lymphoma, leukemia and myeloma which generally has the most severe bone marrow supression), is that if these do not exercise, they are MUCH more likely to die of infection or other preventable complications. While some days, it seems cruel to force them to walk and shower, I have seen that leukemics that we do not push are invariable the ones that have bowels that obstruct, the DVTs and severe respiratory infections. And these things can kill them.
It also promotes a much healthier mindset to have them shower daily and walk in the hall like a normal person. And that healthy mindset will go far to curing them.
My spiritual belief is that G-d does not intend for our bodies to lie there. When we rest too much, our bodies do not work as they should. And we need to push our pts sometimes or we are doing them a disservice.
Just my opinion and experience.