Improving Accurate Use and Evaluating Efficacy of a Neonatal Sepsis Screening Tool

Problem: Non-compliant and inaccurate use of a neonatal sepsis screening tool has hindered statistical validation and dissemination of this neonatal early warning system. The purpose of this project was to improve compliant and accurate use of this screening tool, then evaluate the tool's efficacy in identifying cases of sepsis. Methods: The project assessed pre-intervention compliance and accuracy in using this clinical tool and identified non-compliant and inaccurate users of the tool. Targeted education to non-compliant and inaccurate sub-groups was developed and implemented and nurse champions were utilized to improve compliance and accurate use of the tool. The tool was then evaluated for whether a relationship existed between positive screens and cases of infection. Results: Evaluation of non-compliant, and compliant but inaccurate users of the screening tool found that 62% of non-compliant users were float pool nurses and 38% of compliant, inaccurate users were NICU nurses in their first two years of nursing. Post-intervention evaluation found that compliance improved from 72% to 81% and accuracy improved from 29% to 80%. Of the 75 positive screens identified in the evaluation period, 35 were associated with true infection. Conclusion: The use of nurse champions and targeted education to non-compliant and inaccurate subgroups improved compliance and accuracy in the use of a clinical sepsis screening tool. Additionally, the results of this project confirm cases of infection are identifiable from positive screens identified with use of the Neonatal Shock Sepsis Tool (NSST).