2.50
Hdl Handle:
http://hdl.handle.net/10755/156996
Category:
Abstract
Type:
Presentation
Title:
Critical Care without Borders - Critical Care Resource Nurse
Author(s):
Hewett, Mary K.; Lepman, Deborah; Abdelsamie, Nisrin; Hagaman, Cher
Author Details:
Mary K. Hewett, RN,MS, Hoag Memorial Hospital Presbyterian, Newport Beach, California, USA, email: mhewett@HoagHospital.org; Deborah Lepman; Nisrin Abdelsamie; Cher Hagaman
Abstract:
PURPOSE: Hoag Hospital continues to experience high census causing critically ill patients to be held in the emergency department (ED) and the postanesthesia care unit (PACU). In an effort to provide the same level of care to critically ill patients regardless of their physical location, a critical care resource nurse position was created. DESCRIPTION: The ED identified 11 AM to 11 PM as their highest census period; therefore, this was the time selected for critical care resource nurse coverage. This nursing position is staffed by one of the critical care RNs. Originally this position was created to respond to a patient with sepsis anywhere in the hospital. If a rapid response call is made on the medical/surgical floor and if the patient meets the criteria for early recognition of sepsis, the critical care resource nurse is contacted and responds to the patient's bedside. If the patient is in the ED, the critical care resource nurse is paged directly, responds to the ED, and, using the preprinted standardized order set, manages the patient quickly through administration of antibiotics, within 1 hour, and rapid infusion of intravenous fluids. For tracking purposes, a timeline was created for use by staff to document compliance with the 6-, 12-, and 24-hour bundle thereby ensuring appropriate and timely management of the septic patient. EVALUATION/OUTCOMES:From February to August 2009, a sample of 176 patients on the sepsis protocol was reviewed. Of these, 97% had lactate measured, 75% had blood cultures obtained before antibiotics, 90% had antibiotics administered within the appropriate timeframe, 56% of those eligible received a fluid bolus of 20 mL/kg, 61% of those eligible received a vasopressor to maintain mean arterial pressure (MAP) over 65 mm Hg, and 60% of those eligible received a central catheter. As a result, 65% met the goal of MAP over 65 mm Hg by 6 hours, 48% met the goal of central venous pressure over 8 mm Hg, and 52% met the goal of central venous oxygen saturation over 70%. Overall, patients with severe sepsis, septic shock, or multi-organ failure who underwent the sepsis protocol had a 7.4% mortality rate.
Repository Posting Date:
26-Oct-2011
Date of Publication:
26-Oct-2011
Citation:
2010 National Teaching Institute Research Abstracts. American Journal of Critical Care, 19(3), e15-e28. doi:10.4037/ajcc2010866
Conference Date:
2010
Conference Name:
National Teaching Institute and Critical Care Exposition
Conference Host:
American Association of Critical-Care Nurses
Conference Location:
Washington, D.C., USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleCritical Care without Borders - Critical Care Resource Nurseen_GB
dc.contributor.authorHewett, Mary K.en_GB
dc.contributor.authorLepman, Deborahen_GB
dc.contributor.authorAbdelsamie, Nisrinen_GB
dc.contributor.authorHagaman, Cheren_GB
dc.author.detailsMary K. Hewett, RN,MS, Hoag Memorial Hospital Presbyterian, Newport Beach, California, USA, email: mhewett@HoagHospital.org; Deborah Lepman; Nisrin Abdelsamie; Cher Hagamanen_GB
dc.identifier.urihttp://hdl.handle.net/10755/156996-
dc.description.abstractPURPOSE: Hoag Hospital continues to experience high census causing critically ill patients to be held in the emergency department (ED) and the postanesthesia care unit (PACU). In an effort to provide the same level of care to critically ill patients regardless of their physical location, a critical care resource nurse position was created. DESCRIPTION: The ED identified 11 AM to 11 PM as their highest census period; therefore, this was the time selected for critical care resource nurse coverage. This nursing position is staffed by one of the critical care RNs. Originally this position was created to respond to a patient with sepsis anywhere in the hospital. If a rapid response call is made on the medical/surgical floor and if the patient meets the criteria for early recognition of sepsis, the critical care resource nurse is contacted and responds to the patient's bedside. If the patient is in the ED, the critical care resource nurse is paged directly, responds to the ED, and, using the preprinted standardized order set, manages the patient quickly through administration of antibiotics, within 1 hour, and rapid infusion of intravenous fluids. For tracking purposes, a timeline was created for use by staff to document compliance with the 6-, 12-, and 24-hour bundle thereby ensuring appropriate and timely management of the septic patient. EVALUATION/OUTCOMES:From February to August 2009, a sample of 176 patients on the sepsis protocol was reviewed. Of these, 97% had lactate measured, 75% had blood cultures obtained before antibiotics, 90% had antibiotics administered within the appropriate timeframe, 56% of those eligible received a fluid bolus of 20 mL/kg, 61% of those eligible received a vasopressor to maintain mean arterial pressure (MAP) over 65 mm Hg, and 60% of those eligible received a central catheter. As a result, 65% met the goal of MAP over 65 mm Hg by 6 hours, 48% met the goal of central venous pressure over 8 mm Hg, and 52% met the goal of central venous oxygen saturation over 70%. Overall, patients with severe sepsis, septic shock, or multi-organ failure who underwent the sepsis protocol had a 7.4% mortality rate.en_GB
dc.date.available2011-10-26T19:19:42Z-
dc.date.issued2011-10-26en_GB
dc.date.accessioned2011-10-26T19:19:42Z-
dc.identifier.citation2010 National Teaching Institute Research Abstracts. American Journal of Critical Care, 19(3), e15-e28. doi:10.4037/ajcc2010866en_GB
dc.conference.date2010en_GB
dc.conference.nameNational Teaching Institute and Critical Care Expositionen_GB
dc.conference.hostAmerican Association of Critical-Care Nursesen_GB
dc.conference.locationWashington, D.C., USAen_GB
dc.identifier.citation2010 National Teaching Institute Research Abstracts. American Journal of Critical Care, 19(3), e15-e28. doi:10.4037/ajcc2010866en_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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