Nurses' Early Recognition of Neonatal Sepsis.

OBJECTIVE: To determine nurses' perceptions of the most common physiologic and behavioral indicators of neonatal sepsis.

DESIGN: Descriptive correlational study.

SETTING: A women's and children's hospital in an academic medical center in the southwestern United States.

PARTICIPANTS: Nurses (N = 181) who cared for neonates in the mother-infant and NICU settings.

METHODS: Participants completed an e-mail survey developed from the literature to ascertain their perceptions of which physiologic and behavioral indicators were most often associated with neonatal sepsis. Descriptive and inferential statistics were used to analyze the data.

RESULTS: Participants identified six signs and symptoms as indicators most often associated with sepsis: two were physiologic and four were behavioral. Recognition of these indicators was not related to level of nursing education but was associated with working in the NICU. Seventy-three percent of participants reported that they suspected that newborns were septic before evaluation and diagnosis of septicemia.

CONCLUSION: Nurses can identify the physiologic and behavioral indicators related to neonatal sepsis. Early recognition, expressed as their intuitive knowing, should be considered a valuable clinical tool. Understanding that different practice settings influence identification of signs and symptoms is important. Integration of this knowledge into formal care surveillance could potentially lower the threshold for early evaluation and treatment and thereby improve outcomes.