| Sumario: | Sepsis is one of the leading causes of noncancer-related deaths among oncology patients. The inpatient oncology population possesses many risk factors that increase their susceptibility to developing infection that can rapidly progress to sepsis. Thus, early identification of sepsis is crucial. Our current electronic institutional Sepsis Screening (e-ISS) Tool does not include oncology-specific risk factors. Developing earlier recognition of signs and additional risk factors, lead to better patient outcomes. Therefore, a nurse-led oncology-specific sepsis screening (OSS) tool was created with the goal of identifying sepsis in our patient population that may otherwise be missed using the current tool. Purpose/PICOT: In oncology patients, how does use of an OSS tool, compared to current practices, impact early intervention and recognition of sepsis during hospitalization? An OSS tool was created, which considered: (a) Patients having two or more SIRS criteria, and (b) patient risk factors, including presence of central line, mucositis, neutropenia; age >60, recent steroids or chemotherapy, and history of pneumonia or COPD. The OSS tool was used in conjunction with the e-ISS tool at the start of each shift. If there was a discrepancy between the two tools, nurses were encouraged to advocate for early intervention by contacting the healthcare provider to activate the sepsis bundle, if it had not been activated within 48 hours. Educational posters were also placed at the nursing station to encourage sepsis awareness on the unit. 167 patients were screened from February 2021 to April 2021. 28% of patients screened positive for possible sepsis using both tools. 21% screened positive on the OSS tool, despite screening negative on the e-ISS tool. Most patients who screened positive already had the sepsis bundle activated within 48 hours. However, 5% of patients did not have the bundle activated, and thus early intervention was delivered. Data shows that 21% of oncology patients screened with the e-ISS tool were potential missed positives. This demonstrates the need to broaden the positive sepsis criteria for oncology patients, using oncology-specific risk factors that would otherwise be missed with a universal screening tool. This nurse-led initiative potentially decreased morbidity among our oncology population. Providing the healthcare team with a more user-friendly, OSS tool assists with specialized screening and early intervention.
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