Enhancing Sepsis Prevention in Long-Term Care Facilities: Development of an Infection Prevention Sepsis Toolkit

Objectives: The purpose of this Doctor of Nursing Practice (DNP) project was to create, validate, and refine an Evidence-Based Sepsis Prevention Toolkit to enhanced early sepsis recognition and interprofessional coordination of care within long-term care facilities (LTCFs). Background: Sepsis remains a leading cause of mortality and preventable transfer to the hospital for the elderly residents within the LTCFs. A significant practice gap persists because sepsis in this population often presents atypically, resulting in delayed or inaccurate diagnosis and treatment. Methods: This project was guided by the following PICOT question: For healthcare professionals caring for patients aged 65 years and older in long-term care facilities (P), how might the development of an infection prevention toolkit for sepsis (I), compared to existing practice (C), enhance the coordination of care among healthcare workers, patient communities, and long-term facilities (O)? The process for development was formalized through the CDC’s toolkit development framework and the Evidence-Based Practice (JHEBP) guidelines proposed by the Johns Hopkins Evidence-Based Practice Center. A thorough literature search was conducted, and the toolkit was evaluated by three subject matter experts (SMEs) using Fleiss’s Kappa analysis to assess interrater reliability. Findings: SME feedback resulted in revisions that improved the clarity and usablity of the final toolkit. Although Fleiss’s Kappa indicated marginal agreement ( = 0.13), qualitative feedback was instrumental in refining the toolkit components. The finalized toolkit comprises an expert-approved and holistic Sepsis Prevention Toolkit, including the qSOFA score sheet, recognition charts, staff and the patient education resources, and the step-by-step response plan. Conclusion: This project represents a meaningful step toward developing a clinically relevant, evidence-based recourse to support early sepsis recognition and prevention in LTCFs. Implementation of the toolkit has the potential to reduce sepsis-related morbidity and mortality among older adults in long-term care settings.