Clinical Audit on Fever Workup and Timeliness of Antibiotics Administration in Febrile Patients
DOI:
https://doi.org/10.70749/ijbr.v4i3.3032Keywords:
Fever, Antibiotic Timing, Clinical Audit, Emergency Department, Sepsis.Abstract
Fever is a common presenting complaint in emergency departments and may indicate infections ranging from mild illness to sepsis. Early antibiotic administration is essential, with international guidelines recommending delivery within one hour of clinical suspicion to improve outcomes. A second-cycle closed-loop clinical audit was conducted in a high-volume tertiary care hospital to assess improvements in timeliness of antibiotic administration. A total of 362 febrile patients were included. Interventions after first cycle included staff training standardized fever protocols and real-time monitoring systems. Key outcomes were adherence to one-hour antibiotic benchmark and time intervals across care pathway. Adherence improved from 40% to 75% (p < 0.001). Mean time from diagnosis to antibiotic administration decreased from 95 minutes to 60 minutes while arrival-to-antibiotic time reduced by 41 minutes. Documentation improved and variability decreased. Gender-based disparities were eliminated. However, 25% still experienced delays due to high volume and workflow inefficiencies. System-level interventions significantly improved compliance with time-sensitive guidelines. Persistent delays highlight need for ongoing optimization and monitoring. Workflow redesign and rapid diagnostics are required to eliminate delays and achieve compliance. Audit cycles in clinical governance ensure efficiency and accountability in emergency care. This audit confirms structured interventions improve timely antibiotic administration in febrile patients and supports continuous quality improvement for guideline adherence. Ongoing monitoring leadership engagement and resource optimization remain essential to sustain gains and further reduce delays ensuring consistent high-quality emergency care delivery aligned with international standards across all patient groups consistently achieved.
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