| Sumario: | Significance & Background: Early recognition and timely interventions for sepsis are critical to improve outcomes in oncology patients experiencing this life-threatening event. The Oncology Evaluation and Treatment Center (OETC) is an after-hour clinic serving oncology patients experiencing treatment related complications or uncontrolled symptoms. Approximately 16% of patient visits per month are associated with Systemic Inflammatory Response Syndrome (SIRS). From July 2024 to October 2024, the average door to antibiotic (DTA) time was 177 minutes, high-lighting a need for improved sepsis response. Purpose: The project aimed to improve patient safety and outcomes through sepsis recognition and implementation of treatments with an average DTA time of 90 minutes. Interventions: The first intervention was to leverage the Electronic Health Record (EHR) in identifying the time eligible patients arrived, met SIRS criteria, antibiotic ordered, and administered. Analyze events to identify patterns in efficient and delayed interventions. Findings demonstrated EHR alerts for sepsis were delayed and not reliable. In November 2024 staff received education on the Sepsis Decision Tree and Sepsis Bundle Checklist. DTA time reduced to 114 minutes. In February and March 2025, the DTA time increased to 150 minutes. A root cause analysis revealed delays in receiving lab results and medication availability. Being an after-hours clinic, we did not have a pharmacy team immediately available, and providers relied on order sets for sepsis compliance that contained medications not stocked in the department. Interventions included provider education on sepsis order sets and stocking essential antibiotics, improving order to antibiotic time to 17 minutes. In April 2025 we implemented a point of care (POC) device for measuring patient lactate and chemistry values, key indicators of organ dysfunction in sepsis. This reduced lab turnaround times, decreasing the door to order time to 84 minutes with an overall DTA of 110 minutes for April and May. Results: Nursing timely identification of SIRS and provider notification by the nursing team can improve collaboration on initiating protocols for Sepsis diagnosis. The integration of POC testing and readily available antibiotics improved sepsis diagnosis and treatment efficiency, reducing DTA from 177 minutes to 110 minutes. Discussion: While progress has been made, we have not met our project goal of 90 minutes. Future intervention will include team case reviews, continuing to analyze barriers, and additional technologic solutions to further enhance sepsis care in the OETC.
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