NAOG Audit and Education Event 19 th April 2013 South Tyneside District Hospital AOS Nurse Rebecca Thomas

Acute oncology service. 1 full time AOS Nurse, supported by chemotherapy unit, specialist nurses and lead cancer nurse Outside hours, senior nurses in EAU have a resource folder and bleep. Patients encouraged to speak to chemo unit during working hours. Electronic flagging system captures all patients with a history of cancer.

Service development Dec ‘12-Apr ‘13 Patient information leaflet implemented for all patients receiving chemotherapy. Chemotherapy unit now using UKONS tool to triage calls from patients, PGD has been requested for first dose of Tazocin for patients with neutropenic sepsis (Application awaiting approval). Teaching has been carried out in key areas on Sepsis and MSCC Awareness of CUP and AOS service has been raised across hospital. Change in hospitals blood culturing policy to enable nurses to perform cultures as part of’ hour door to needle pathway’.

Audit information. 160 patients were captured by flagging system between February and March patients required AOS intervention

The AOS service has helped to reduce the length of stay of patients, specifically those with Neutropenic Sepsis and MSCC.

Neutropenic Sepsis Audit A retrospective audit was conducted on Neutropenic Sepsis Coded patients presenting to STFT between April 2012 and March patients were captured in the audit. 5 patients did not have an oncological diagnosis 13 patients were not neutropenic

Neutropenic Sepsis cont. 18 patients had confirmed neutropenic sepsis. All but 1 case appeared to coincide with chemotherapy treatment. 4 patients out of 18 were given antibiotics within an hour of presentation. (22%) Time to antibiotics was at best 30 mins and at worst 4 hours.

Neutropenic Sepsis. During the audit it became evident, patients were being triaged within the 30 minute target however waited on average a couple of hours for an antibiotic prescription. It is hoped that by increasing awareness amongst A+E staff, this will drastically improve. PGD for triage nurses also set to drastically improve on these results. Increased visibility of AOS nurse has already improved things significantly.