Neutropenic Precaution Policies

[bc130]

Hi, I'm trying to revise our institution's policy for neutropenic precautions in the pediatric setting. What I would like is for people to share the policy at their institution and then I will do a lit search to support any recommendations. What does your institution consider neutropenic? No fresh fruits for those patients? Do you have a different policy for severe neutropenia (ANC

Any help is greatly appreciated! Thanks in advance.

Beth

[nrsang97, BSN, RN]

Our policy is Absolute neutrophil count less than 1000. No fresh flowers on our unit at all anyway (ICU). Pt not allowed to have fresh fruit from family or dinner trays. If med surg pt not allowed to have fresh flowers in room either. No different policy for ANC

[miko014]

No food restrictions for us anymore. I'm on a committee that just reviewed our new policy - it hasn't ""hit the stands" yet, but it will soon. We used to restrict food, but not anymore. Studies have shown that as long as fruit and veggies are washed, there should be no problems. After all, what are you supposed to eat to improve your health? Though after all this tomato business, you have wonder, right?? Anyway, we do restrict live or cut flowers. Doors have to be shut and pt must have a private room with a HEPA filter. They need a positive air flow room if they have it 2 weeks or longer. ANC

A big thing that is hard to get some of the non-heme/onc guys to do is that new febrile neutropenia is a medical emergency!!!!! That is in our policy, but a lot of the HOs and the guys that cover at night are like "so what, it's just a fever, give him some tylenol". They're getting better about it. We also have problems with lab because they are supposed to draw blood cultures stat-life threat. They always say BCx are not stat, and we say we know they are not RUN stat but they need to be DRAWN stat. Febrile neutropenia is never ever good, but when it's new, it needs to be addressed super stat and it's listed in our policy that way.

Hope that helps!

[rn undisclosed name]

Our policy is basically the same. We also restrict plants and some visitors. If they have a cold we strongly discourage them from visiting.

In addition, if they want to walk in the halls they have to wear a mask for their own protection.

I work on an oncology floor and if a patient develops a neutropenic fever we have a standing set of neutropenic orders that we initiate. This includes blood cultures x2, urinalysis, urine culture, Tylenol, and antibiotics if the patient is not already on them. We try to get everything initiated within 30 minutes.