LAUSR

©2018 American Association of Critical-Care Nurses doi:https://doi.org/10.4037/ccn2018245 QGiven all the changes in sepsis definitions, what is the best way to know if a patient is at risk for sepsis? be used in the ICU as part of the diagnostic criteria for sepsis.1 The key clinical point is the need for ongoing monitoring of patients for indications of organ dysfunction. If a patient has indications of organ dysfunction (regardless of the cause or which screening tool is used), further assessment is required. The challenge is that there is no consensus on how to screen for or diagnose sepsis. The 2016 Surviving Sepsis guidelines,5 which were based on evidence using the old sepsis definitions, did not include the Sepsis-3 criteria. Rather, those guidelines recommend ongoing screening, without specifying the criteria. Because the debate about the appropriate screening criteria for sepsis is ongoing,6-10 it is important to know what each score does and does not tell you (Table 3). An important consideration is that a normal qSOFA or SOFA score does not rule out sepsis,9 because no screening tool is “perfect” (ie, has 100% diagnostic accuracy). Additionally, the accuracy of each score varies depending on whether the patient is in the emergency department, the ICU, or a non-ICU setting.1,13,14 Several excellent review papers address this challenging question, including the use of AElizabeth Bridges, PhD, RN, CCNS, FCCM, FAAN,