PP-23 Development of a standard operating procedure to enhance confidence in assessing and escalating patients with possible sepsis within a hospice environment

<h3>Introduction</h3> 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. <h3>Aims</h3> 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. <h3>Methods</h3> 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. <h3>Results</h3> On a seven-question quiz regarding sepsis escalation, scores significantly improved using the SOP (p&lt;0.01). The focus group reported increased confidence in evaluating and escalating patients utilising this SOP (p&lt;0.05), and increased confidence in utilising personalised adjusted EWS score (p&lt;0.05). <h3>Conclusion</h3> Implementation of the SOP significantly improved nursing staff confidence and skill in assessing and escalating potential sepsis cases in hospice settings based on EWS. <h3>Impact</h3> The use of this SOP including ‘personalised’ EWS enhances patient-centred care and supports better sepsis management and physical wellbeing in hospice environments.