To KP or not to KP: a retrospective cohort study

Neonatal sepsis is a leading cause of neonatal mortality; however, it is also acknowledged that current guidelines overtreat this condition. Some units across the UK have transitioned to the Kaiser Permanente (KP) sepsis risk calculator (KPSRC) in an effort to reduce unnecessary early onset neonatal sepsis (EONS) screens. This study compares the sensitivity and specificity of the KPSRC to current guidance using a retrospective cohort approach. It aims to identify whether the use of the KPSRC has the potential to reduce unnecessary bed days without resulting in a potential increase in missed cases of sepsis.

Rosie Roots
Paediatric ST5 Registrar
Croydon University Hospital
rosie.roots@nhs.net

Christine Hesketh
Paediatric ST6 Registrar
Evelina London Children's Hospital

Salim Yasin
Consultant Paediatrician
Queen Mary's Hospital for Children, Carshalton, Surrey

Roots R., Hesketh C., Yasin S. To KP or not to KP: a retrospective cohort study. Infant 2024; 20(2): 59-63.

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Keywords

early onset neonatal sepsis (EONS); sepsis; Kaiser Permanente sepsis risk calculator (KPSRC)

Key points

This study reinforces that transitioning to a new protocol could cut down on unnecessary septic screens, however, there is a potential risk of missed cases of EONS.
There is need for substantial training, robust supervision and safety mechanisms during the transition process.
Rationalising the definition of sepsis to better risk stratify culture-negative sepsis could make EONS risk calculators more accurate. The current definition used in clinical practice does not reflect the definition of neonatal sepsis used for research purposes.

Also published in Infant:

VOLUME 16/ISSUE 1, JANUARY 2020

Sepsis and central line-associated neonatal infection: a care bundle QI project

Neonatal late-onset sepsis (LOS) is a significant cause of mortality and morbidity within neonatal units. These infections are often associated with the insertion and use of central lines. Data from 2017 identified the local neonatal unit at Gloucestershire Hospitals NHS Foundation Trust as an outlier with above average rates of LOS. A quality improvement (QI) project was therefore created with the aim of reducing rates of central line-associated sepsis.