PP-23 Development of a standard operating procedure to enhance confidence in assessing and escalating patients with possible sepsis within a hospice environment
Year: 2025
Type: conference-paper
Abstract: Introduction Sepsis is a life-threatening condition requiring prompt recognition and intervention. In hospice settings, a patient-centred approach is essential, as patients may have abnormal baseline observations due to underlying conditions, and not all are suitable for intensive interventions. As hospices serve a wide range of patients, including those appropriate for urgent hospital transfer to those receiving end of life care, a clear guideline is needed to address all patient groups. Aims Develop a standard operating procedure (SOP) to support nursing teams in timely escalation of patients with high early warning scores, while ensuring a patient-centred approach to each case. Methods We evaluated existing NICE guidelines exploring early warning scores (EWS), consulted hospice nursing and medical staff, and reviewed the use of EWS in other hospice environments. A SOP was created to aid in assessing and escalating patients with high early warning scores. The SOP included a clear flow chart for escalation, and options for ‘adjusted’ or ‘personalised’ EWS for those patients who have baseline irregular observations, to avoid unnecessary escalation. A small focus group of nurses reviewed the SOP, with pre- and post-implementation questions on clinical scenarios and confidence. Data was evaluated using the two-tailed Wilcoxon-signed rank test. Results On a seven-question quiz regarding sepsis escalation, scores significantly improved using the SOP (p<0.01). The focus group reported increased confidence in evaluating and escalating patients utilising this SOP (p<0.05), and increased confidence in utilising personalised adjusted EWS score (p<0.05). Conclusion Implementation of the SOP significantly improved nursing staff confidence and skill in assessing and escalating potential sepsis cases in hospice settings based on EWS. Impact The use of this SOP including ‘personalised’ EWS enhances patient-centred care and supports better sepsis management and physical wellbeing in hospice environments.
Authors: Emma Livesey, Joanna George, Sarah Burns, Laura Chapman
Institution: Marie Curie
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W4407284983