Sepsis Education and Successful Implementation of a Sepsis Recognition and Management Workflow in an Inpatient Pediatric Hematologic Oncologic Unit.

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.