(1578) Development of a Novel Pediatric Sepsis Screening Tool for Home Care

Introduction: Early detection of Pediatric sepsis is associated with improved outcome. A literature review of international sepsis screening processes revealed a lack of home care screening tools for pediatrics. Cases are often missed in the community because existing criteria use multiple age categorizations and require laboratory data. The purpose of the study was to create a Pediatric Sepsis Screening Package to simplify home screening, identify significant risk factors necessitating care escalation, and empower parents and caregivers to recognize sepsis signs early.

Methods: An interdisciplinary committee, Pediatric Sepsis Steering Committee (PSSC), was created. It consisted of four New York home care agencies, critical care physicians, sepsis experts, and national organizations. The PSSC identified specific challenges in detecting sepsis in children and developed a three-age specific Screening Package for use by nurses during home visits. Screening Tools, an Algorithm and Protocol, and an educational Zone Tool. Screening criteria incorporate Severe Inflammatory Response Syndrome (SIRS) criteria, potential infection sites, infection history, and new-onset organ dysfunction symptoms, all tailored for pediatrics.

Results: Following the tool's development, 13 clinicians from four New York home care organizations were trained. A 30-day beta test involved using the tool in every clinical visit, totaling 90 screenings. 73% of cases showed no sepsis risk factors, while 26% indicated potential infection risks based on medical history, with all such cases referred to the Zone Tool for education. In a usability survey, two-thirds of trained clinicians supported statewide implementation with improved training, 71% found the package consistent, user-friendly, and accurate, and 77% endorsed the Zone Tool's effectiveness in educating caregivers about sepsis.

Conclusions: Preliminary results from clinicians indicate that the Pediatric Sepsis Screening Package effectively addresses the gap in sepsis screening for pediatric patients in home care settings. The tools are now used by home care agencies in 58 of New York's 62 counties, with ongoing data collection for refinement. The tools’ development and success exemplify a collaborative approach to managing complex health conditions across various sectors.