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Sunderland Neutropenic Sepsis Audit Melanie Robertson – Nurse Consultant Oncology

Sunderland Neutropenic Sepsis Audit Melanie Robertson – Nurse Consultant Oncology. Neutropenic Sepsis. January 2012 to December 2012 Total Number of Patients with suspected Neutropenia – 137 Haematology 99 Oncology 38 Total Number pts confirmed Neutropenia – 103. Neut Sepsis pathways.

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Sunderland Neutropenic Sepsis Audit Melanie Robertson – Nurse Consultant Oncology

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  1. Sunderland Neutropenic Sepsis Audit Melanie Robertson – Nurse Consultant Oncology

  2. Neutropenic Sepsis January 2012 to December 2012 Total Number of Patients with suspected Neutropenia – 137 Haematology 99 Oncology 38 Total Number pts confirmed Neutropenia – 103

  3. Neut Sepsis pathways Number of Pathways completed – 47 CHDU – 31 A+E -9 B28 – 7 AMU – 0 Number of Pathways not completed – 90 CHDU – 29 A+E – 35 B28 – 18 AMU – 8

  4. Antibiotics administered Antibiotics time administered from admission Within 1 hour – 71 (51%) 1-2 Hrs – 25 (18%) 2-3 Hrs – 6 (4%) 3-4 Hrs – 3 (2%) Documentation unclear or no time specified (for admission or antibiotics) – 32 (23%)

  5. Traffic light table

  6. Actions Updated neutropenic sepsis pathway Encourage use of Neutropenic sepsis pathway Integrate pathway to electronic health records Increased training to recognise neutropenic sepsis (medical induction training) CQUIN target – RCA for patients not achieving 1 hour target.

  7. Meditech v6

  8. Auditing and Measuring outcomes

  9. Auditing and Measuring outcomes Analysis of emergency re-admission rates of patients with a diagnosis of cancer 2009 Patient re-admissions 1283 2011 Patient re-admissions 924 Analysis of average LOS of emergency re-admissions of patients with a diagnosis of cancer 2009 Average LOS 6 days 2011 Average LOS 5 days

  10. Emergency readmissions

  11. Emergency readmissions by tumour group

  12. Length of stay

  13. Length of stay by tumour group

  14. Auditing and Measuring outcomes Re-admissions audit Specifically patients admitted within 30 days of planned chemotherapy 68% of admissions not via Oncology mean admission date following chemo administration was 9.8 days Around 80% of patients were Breast/Lung/Colon Around 70% were receiving palliative chemotherapy Commonly admitted after Course 1 (C4) Average LOS 6.5 days (2009) 5 days (2010)

  15. Next Steps Lung Acute Oncology Nurse Introduce RAPA tool to identify more patients / patients at earlier step e.g. A&E Develop further ambulatory pathways Uncomplicated neutropenic sepsis Hickman line infection AOS Nurse Practitioner education Prescribing ECG Interpretation Radiology Interpretation Implementation of Advanced care planning (ACP) in Oncology Radiology requesting

  16. AOS traininghttp://www.test.elearninglaboratory.co.uk/AO/story.html

  17. Thank Youmelanie.robertson@chsft.nhs.uk

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