{
  "abstract": "Introduction Sepsis causes over 20% of deaths annually, with early recognition and management being key strategies to preventing patient deterioration. Despite being the largest group of hospital-based clinicians, the role of registered nurses (RNs) in sepsis remains poorly defined.Objective To describe the roles and responsibilities of RNs in early recognition and management of sepsis in acute hospital settings, applying the Action, Actor, Context, Target and Time (AACTT) Implementation Science Framework to specify nursing behaviours across domains, and identify evidence gaps to inform future research and practice.Methods The review was conducted using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist. We searched Medline, EMBASE, CINAHL and PubMed for studies discussing the contribution of RNs in acute hospital-based sepsis care. Data were extracted and mapped to the AACTT framework domains.Results 27 (90%) of 30 included studies described RNs as the actor responsible for the action of sepsis screening. 26 studies (87%) described RN actions relating to timely care escalation and sepsis management. A broader range of actions was identified in resource-restricted contexts, with three (10%) studies reporting RN-initiated blood tests, chest X-rays, intravenous fluids and antimicrobials.Across 16 studies (53%), eight roles with dedicated focus on sepsis identification and management were identified; only one study outlined formal training requirements. Nurse practitioners were excluded here given their credentialed role and scope.Conclusion Nurses perform essential actions in early sepsis recognition and management, with several RN roles focused on sepsis care identified. A broader scope of nurse-initiated actions was identified in resource-restricted contexts to meet clinical demand. There is potential for a greater scope of nursing actions in sepsis care for the benefit of patients and health services, but to achieve this, standardised training requirements need to be developed, and scope of practice defined.",
  "authors": [
    {
      "affiliations": [
        "Sir Peter MacCallum Department of Oncology, The University of Melbourne Faculty of Medicine Dentistry and Health Sciences, Melbourne, Victoria, Australia",
        "NHMRC National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia"
      ],
      "name": "Alison Y Lemoh"
    },
    {
      "affiliations": [
        "National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia",
        "Royal Melbourne Hospital Guidance Group, The Royal Melbourne Hospital, Melbourne, Victoria, Australia"
      ],
      "name": "Zohal Rashidzada"
    },
    {
      "affiliations": [
        "Department of Nursing",
        "Sir Peter MacCallum Department of Oncology, University of Melbourne VCCC, Parkville, Victoria, Australia",
        "Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia"
      ],
      "name": "Mei Krishnasamy"
    },
    {
      "affiliations": [
        "Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia"
      ],
      "name": "Aileen Wilkinson"
    },
    {
      "affiliations": [
        "Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia"
      ],
      "name": "Rebecca Blackwood"
    },
    {
      "affiliations": [
        "Department of Clinical Haematology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia",
        "Department of Clinical Haematology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia"
      ],
      "name": "Alexandra Rivalland"
    },
    {
      "affiliations": [
        "National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia",
        "Royal Melbourne Hospital Guidance Group, The Royal Melbourne Hospital, Melbourne, Victoria, Australia"
      ],
      "name": "Courtney Ierano"
    },
    {
      "affiliations": [
        "National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia",
        "NHMRC National Centre for Infections in Cancer, Sir Peter MacCallum Department of Oncology, Centre for Health Services Research in Cancer, Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia"
      ],
      "name": "Karin A Thursky"
    },
    {
      "affiliations": [
        "Centre for Health Services Research in Cancer, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia",
        "Department of Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia"
      ],
      "name": "Lisa Guccione"
    }
  ],
  "title": "Roles and responsibilities of registered nurses in the early recognition and management of sepsis in acute hospital settings: a scoping review",
  "uid": "491a24a8-0021-5115-9d5c-d438c0db168d"
}