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Sepsis Prevention in the Geriatric Oncology Patient

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Sepsis Prevention in the Geriatric Oncology Patient

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    1. Sepsis Prevention in the Geriatric Oncology Patient Jean Konicke RN ONC The Methodist Hospital, M8NW Oncology/Hematology June 17, 2008

    2. Improved recognition of the vague signs and symptoms of infection in the geriatric patient.

    3. JCAHO Meets JCAHO age-specific competency requirements for staff. Meets JCAHO National Patient Safety Goal, “Improve recognition and response to changes in a patient’s condition.”

    4. Introduction Problem: A lack of awareness of the vague presentation of illness in older adults. How problem was selected: Because age is one of the risk factors for cancer, the clinical areas of oncology and gerontology overlap significantly. With chemotherapy induced neutropenia, oncology nurses need to be keenly aware of the presentation of infection in the older patient population. Target Population: 70 years and older Purpose of CAP: Sepsis prevention through improved recognition of the vague signs and symptoms of infection in the geriatric oncology patient.

    5. Needs Assessment Unit: Twenty eight bed, acute care ,onc/heme unit. Average age of patient population is about 60 yrs. and is expected to increase due to the rapidly growing elderly population. Benefit to the unit and patient is a decrease in length of stay, decrease in readmission rate, decrease morbidity and mortality, and increase in quality of life. Resource used to support CAP at TMH is paid time off to attend workshops. Affected personnel: RNs, PCAs, as well as patients and their caregivers.

    6. Project Model Goal: Improved patient outcomes. Behavioral Objectives: Nurses will demonstrate understanding of increased risk for sepsis in the geriatric cancer patient due to vague presentation of infection. Expected Outcomes: Improved assessment skills and more effective patient/family teaching. Methodology: Large poster presentation, post evaluation.

    7. Project Presentation Poster: 5 feet x 3 ½ feet Information addressed included the following: 1. Physiological reasons why elderly patients are at a greater risk for chemotherapy toxicity and more severe myelosuppression. 2. The subtle symptoms that may represent infection in geriatric patients. 3. The cost of sepsis in dollars and loss of life.

    8. Project Presentation 4. Common sites for infection in the elderly. 5. Common sites for infection in the oncology patient. 6. Assessment criteria. 7. Patient/Caregiver education.

    9. Catch Symptoms Early!

    10. Before they get out of hand!

    11. Your patients will thank you!

    12. Projected Cost Analysis Supplies: printer ink, paper, foam board, poster board, construction paper, foam letters, adhesive, and book. $125.00 Nursing Hours: Workshop hours, brainstorming, research hours, and putting project together. $5,200.00 ---------------- $5,325.00

    13. Evaluation Evaluation of CAP was done through anonymous post presentation evaluation tool. Staff felt that they were better able to care for the geriatric patient and would incorporate knowledge in their patient/family teaching. M8NW is committed to ongoing geriatric education.

    14. Conclusion Summarization: Heightened awareness of the often very subtle signs of infection in the elderly will reduce the risk of sepsis. Strengths: Evaluations indicated that presentation was well organized and information was useful and relevant to our patient population. Weaknesses: Not measurable.

    15. References Balducci, Lodovico, MD. “The Older Cancer Patient.” New York, NY: Springer, 2003. Hartford Institute for Geriatric Nursing. “Atypical Presentations.” http://consultgerin.org/topics/atypical_presentation/want_to_know (2008) Mezey, Mathy, EdD, RN, FAAN. “Geriatric Nursing Protocols for Best Practice.” New York, NY: Springer, 2003. Moran, Deborah, MD. “Clinical Geriatrics-Infectious Disease Emergencies in Older Adults.” http://www.clinicalgeriatrics.com/article/1003. (2008)

    16. References Morley, John, MD. “Aging Successfully-Sepsis.” Division of Geriatric Medicine at St. Louis University School of Medicine, Geriatric Research Center. http://medschool.slu.edu/agingsuccesfully/ (2008) Repetto, Lazaro, MD. “Greater Risks of Chemotherapy Toxicity in Elderly Patients with Cancer.” www.SupportiveOncology.net (2008)

    17. Thank You!

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