No Nurse Left Behind: Sharing The Lessons Learned after 4 Years of the Surviving Sepsis Campaign

2.50
Hdl Handle:
http://hdl.handle.net/10755/157161
Category:
Abstract
Type:
Presentation
Title:
No Nurse Left Behind: Sharing The Lessons Learned after 4 Years of the Surviving Sepsis Campaign
Author(s):
Pyle, Kirsten
Author Details:
Kirsten Pyle, Mission Hospital, Mission Viejo, California, USA, email: kirsten.springer@yahoo.com
Abstract:
PURPOSE: In response to the unacceptably high morbidity and mortality of severe sepsis and septic shock patients, the adoption of the Surviving Sepsis Campaign (SSC) guidelines was instituted in a non-for-profit, community, trauma hospital. Our goal was to reduce morbidity and mortality, to drive compliance with the bundle elements, and to create a culture change. For our goals to be accomplished we had to engage every nurse on every unit; no nurse left behind. Description: Knowing the SSC may be more difficult to implement than other evidence based therapies, the initiative was driven by a dedicated sepsis coordinator. We had a trauma coordinator and a stroke coordinator, why not a sepsis coordinator? Utilizing Meditech, we were easily able to capture robust data from the SICU, CICU and med/surg wards. We utilized statistical analysis to determine efficacy. We analyzed the systems in place, the care provided and patient outcomes. Essential for success, we paid attention to the lessons learned nationally over the past 4 years surrounding sepsis implementation. A "tool-kit" approach with broad, house-wide implementation was completed. 10 multidisciplinary groups collaborated to produce a "root-cause analysis" on each barrier to implementation. Emergency, critical care and medical/surgical units worked with one focus in mind: patient flow, communication across units and problem solving areas of opportunity. Since implementation, we have full data on 76 patients with severe sepsis or septic shock who were admitted with an intent-to-treat and had at least one critical care bed day. EVALUATION: When compared against 2007 (n=57) data, in-hospital mortality from 29.8% to 15.8% (p<0.05). The percent of respiratory failure requiring intubation was reduced from 58% to 35% (p<0.05). The percent of sepsis patients who developed acute renal failure requiring hemodialysis was reduced from 18% to 11% (p=0.32). Compliance with early goal directed therapy improved from 0% to 71% and the rate of lactate screening increased from 63% to 96% (both p<0.05). A dedicated sepsis coordinator with a clear understanding of common barriers in sepsis care can more easily develop creative, house-wide system solutions and may increase the probability of successful implementation.
Repository Posting Date:
26-Oct-2011
Date of Publication:
26-Oct-2011
Citation:
2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.
Conference Date:
2009
Conference Name:
National Teaching Institute and Critical Care Exposition
Conference Host:
American Association of Critical-Care Nurses
Conference Location:
New Orleans, Louisiana, 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.titleNo Nurse Left Behind: Sharing The Lessons Learned after 4 Years of the Surviving Sepsis Campaignen_GB
dc.contributor.authorPyle, Kirstenen_GB
dc.author.detailsKirsten Pyle, Mission Hospital, Mission Viejo, California, USA, email: kirsten.springer@yahoo.comen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157161-
dc.description.abstractPURPOSE: In response to the unacceptably high morbidity and mortality of severe sepsis and septic shock patients, the adoption of the Surviving Sepsis Campaign (SSC) guidelines was instituted in a non-for-profit, community, trauma hospital. Our goal was to reduce morbidity and mortality, to drive compliance with the bundle elements, and to create a culture change. For our goals to be accomplished we had to engage every nurse on every unit; no nurse left behind. Description: Knowing the SSC may be more difficult to implement than other evidence based therapies, the initiative was driven by a dedicated sepsis coordinator. We had a trauma coordinator and a stroke coordinator, why not a sepsis coordinator? Utilizing Meditech, we were easily able to capture robust data from the SICU, CICU and med/surg wards. We utilized statistical analysis to determine efficacy. We analyzed the systems in place, the care provided and patient outcomes. Essential for success, we paid attention to the lessons learned nationally over the past 4 years surrounding sepsis implementation. A "tool-kit" approach with broad, house-wide implementation was completed. 10 multidisciplinary groups collaborated to produce a "root-cause analysis" on each barrier to implementation. Emergency, critical care and medical/surgical units worked with one focus in mind: patient flow, communication across units and problem solving areas of opportunity. Since implementation, we have full data on 76 patients with severe sepsis or septic shock who were admitted with an intent-to-treat and had at least one critical care bed day. EVALUATION: When compared against 2007 (n=57) data, in-hospital mortality from 29.8% to 15.8% (p<0.05). The percent of respiratory failure requiring intubation was reduced from 58% to 35% (p<0.05). The percent of sepsis patients who developed acute renal failure requiring hemodialysis was reduced from 18% to 11% (p=0.32). Compliance with early goal directed therapy improved from 0% to 71% and the rate of lactate screening increased from 63% to 96% (both p<0.05). A dedicated sepsis coordinator with a clear understanding of common barriers in sepsis care can more easily develop creative, house-wide system solutions and may increase the probability of successful implementation.en_GB
dc.date.available2011-10-26T19:28:33Z-
dc.date.issued2011-10-26en_GB
dc.date.accessioned2011-10-26T19:28:33Z-
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.conference.date2009en_GB
dc.conference.nameNational Teaching Institute and Critical Care Expositionen_GB
dc.conference.hostAmerican Association of Critical-Care Nursesen_GB
dc.conference.locationNew Orleans, Louisiana, USAen_GB
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_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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