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Sepsis Education and Successful Implementation of a Sepsis Recognition and Management Workflow in an Inpatient
Lindsey Blankenship1, Kathleen Demmel1, Tammy Otis1
1Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Insights
Implementing a Sepsis Algorithm in a pediatric hematology-oncology unit improved nurses' sepsis recognition and management. This initiative achieved zero sepsis-related mortality, demonstrating improved patient outcomes.
Area of Science:
- Pediatric critical care medicine
- Oncology nursing
- Infectious disease management
Background:
- Sepsis is a major cause of pediatric morbidity and mortality globally.
- Children with underlying conditions, especially neoplastic diseases, face higher sepsis risks.
- Effective pediatric sepsis management is crucial, particularly in vulnerable populations.
Purpose of the Study:
- To implement and evaluate a Sepsis Algorithm in a pediatric hematology-oncology unit.
- To enhance nurses' ability to recognize, manage, and treat pediatric sepsis and septic shock.
- To assess the impact of the algorithm on patient outcomes and mortality.
Main Methods:
- A 4-year implementation of a Sepsis Algorithm in a 42-bed pediatric hematology-oncology unit.
- Algorithm elements included education, quality improvement, and prevention interventions.
- Pre- and post-educational assessments monitored nurse understanding and compliance.
Main Results:
- Nurses showed improved understanding of sepsis recognition and prevention.
- Achieved 10.7% Sepsis Algorithm compliance and 24.7% improvement in antibiotic administration within 1 hour.
- Maintained a zero mortality rate related to sepsis or septic shock within the unit.
Conclusions:
- The Sepsis Algorithm implementation was successful in a pediatric hematology-oncology setting.
- The algorithm enhanced bedside nurses' sepsis management knowledge and skills.
- The initiative significantly improved patient outcomes by reducing sepsis-related mortality.
Abstract:
Sepsis is a leading cause of morbidity, mortality, and healthcare utilization for children worldwide. Forty-nine percent of pediatric sepsis patients have an underlying condition rendering them more susceptible to infection. One in six severe sepsis patients has an underlying neoplastic disease and has a 30% higher risk of death compared to other severe sepsis patients. Consequently, focus on pediatric sepsis management is paramount. In a 42-bed pediatric hematology-oncology unit, a Sepsis Algorithm was implemented aimed to improve nurses' ability to recognize, manage, and treat suspected and early sepsis and septic shock over a 4-year period. This algorithm consisted of various elements including ongoing educational offerings, quality improvement methodologies, and sepsis prevention interventions. The sepsis workflow provided targeted care guidelines and aligned interventions previously proven to improve patient outcomes. Pre- and posttests were administered with each educational offering to monitor effectiveness. Nurses demonstrated higher levels of understanding of sepsis recognition and prevention efforts following educational activities. Consequently, a 10.7% Sepsis Algorithm compliance and a 24.7% antibiotic administration within 1 hr compliance improvement was realized. Utilization of the Sepsis Algorithm contributed to maintaining a mortality rate of zero related to sepsis and/or septic shock while patients were in the hematology-oncology unit. Bedside nurses' sepsis management knowledge improved. The Sepsis Algorithm implementation was successful and improved patient outcomes.
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