2.50
Hdl Handle:
http://hdl.handle.net/10755/166384
Category:
Abstract
Type:
Presentation
Title:
Adoption of an Electronic Screening Tool for Septicemia
Author(s):
Greco, Sheryl; Granich, Marion; Johnson, Lari; Jackson, Kim; Sayre, Cindy
Author Details:
Sheryl Greco, RN, MN CCRN, at University of Washington Medical Center, email: sagreco@u.washington.edu; Marion Granich, RN, BSN, CSS; Lari Johnson, RN, MN; Kim Jackson, RN, BSN; Cindy Sayre, RN, MSN, APRN
Abstract:
HEALTHCARE ORGANIZATION DESCRIPTION: The University of Washington Medical Center is a 400-bed, public academic medical center offering comprehensive primary and specialty care. BACKGROUND OF PRACTICE INNOVATION: Sepsis mortality rates remain among the top ten for all diagnoses in the nation, despite international recommendations for early diagnosis / treatment. The University of Washington Medical Center reviewed ICD-9 code data for patients in 2005 diagnosed with septicemia, which revealed a mortality rate of 39% for patients diagnosed positive. PRACTICE INNOVATION PURPOSE: To adopt an electronic screening tool to aid bedside clinicians in early recognition of patients at risk for sepsis. PRACTICE INNOVATION QUESTIONS: Will adoption of an automatic screening tool embedded in the electronic medical record provide a simple and efficient way to identify patients at risk for sepsis and improve the outcomes for patients with sepsis? PRACTICE INNOVATION IMPLEMENTATION: Methods: A structured approach to identify and treat patients at risk for septicemia was developed in December 2006 and implemented in March 2007. A sepsis screening tool was incorporated into the electronic medical record and included entries for suspected infection, two systemic inflammatory response (SIRS) markers, and hypoperfusion indices (MAP < 65mmHg, serum lactate > 4 mmol/L). After the screen is complete, the RN receives a computerized message to re-screen if the patient screens negative and to contact the MD if the patient screens positive for sepsis. Physician order sets were designed using evidenced-based recommendations from the Surviving Sepsis Campaign for all patients screening positive. Sepsis education (pathophysiology, early identification, treatment) was implemented on all nursing units throughout the medical center. PRACTICE INNOVATION OUTCOMES: Before implementing the screen, there was no systematic approach to identify and treat patients with sepsis. The automatic sepsis screening tool has been welcomed by nursing staff as an efficient way to aid the early identification of patients with sepsis. The screen requires minimal data entry by the RN since data are pulled from other sources and the screen provides immediate feedback describing the patientÆs risk. In addition, electronic entry allows for tracking and aggregating data elements for ongoing analysis. In the initial 7 months of implementation of the screening tool, 163 of 6570 patients across the medical center (2.5%) screened positive. Mortality rates decreased after implementation: pre: 2005 121/310 (39%), 2006 103/280 (37%) and post: 2007 65/211 (2005 vs 2007 p = .06; 2006 vs 2007 NS), and the number of patients identified in 2007 is projected to exceed previous years by 17% - 29%. CONCLUSIONS: Implementation of evidenced-based practice guidelines for sepsis requires a simple system for early identification of patients at risk. Using technology to assist clinicians to recognize sepsis early is an important step to early implementation of treatments that can have a direct effect on mortality. Recommendations for future actions include further study and data analysis to evaluate the sensitivity and specificity of the sepsis screen elements in various patient populations, and consideration of automatic paging to the STAT RN on the Rapid Response Team for occurrences of positive sepsis screens.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2008
Conference Name:
ANCC Magnet Practice Innovations
Conference Host:
American Nurses Credentialing Center
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 for further details regarding this item.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleAdoption of an Electronic Screening Tool for Septicemiaen_GB
dc.contributor.authorGreco, Sherylen_US
dc.contributor.authorGranich, Marionen_US
dc.contributor.authorJohnson, Larien_US
dc.contributor.authorJackson, Kimen_US
dc.contributor.authorSayre, Cindyen_US
dc.author.detailsSheryl Greco, RN, MN CCRN, at University of Washington Medical Center, email: sagreco@u.washington.edu; Marion Granich, RN, BSN, CSS; Lari Johnson, RN, MN; Kim Jackson, RN, BSN; Cindy Sayre, RN, MSN, APRNen_US
dc.identifier.urihttp://hdl.handle.net/10755/166384-
dc.description.abstractHEALTHCARE ORGANIZATION DESCRIPTION: The University of Washington Medical Center is a 400-bed, public academic medical center offering comprehensive primary and specialty care. BACKGROUND OF PRACTICE INNOVATION: Sepsis mortality rates remain among the top ten for all diagnoses in the nation, despite international recommendations for early diagnosis / treatment. The University of Washington Medical Center reviewed ICD-9 code data for patients in 2005 diagnosed with septicemia, which revealed a mortality rate of 39% for patients diagnosed positive. PRACTICE INNOVATION PURPOSE: To adopt an electronic screening tool to aid bedside clinicians in early recognition of patients at risk for sepsis. PRACTICE INNOVATION QUESTIONS: Will adoption of an automatic screening tool embedded in the electronic medical record provide a simple and efficient way to identify patients at risk for sepsis and improve the outcomes for patients with sepsis? PRACTICE INNOVATION IMPLEMENTATION: Methods: A structured approach to identify and treat patients at risk for septicemia was developed in December 2006 and implemented in March 2007. A sepsis screening tool was incorporated into the electronic medical record and included entries for suspected infection, two systemic inflammatory response (SIRS) markers, and hypoperfusion indices (MAP < 65mmHg, serum lactate > 4 mmol/L). After the screen is complete, the RN receives a computerized message to re-screen if the patient screens negative and to contact the MD if the patient screens positive for sepsis. Physician order sets were designed using evidenced-based recommendations from the Surviving Sepsis Campaign for all patients screening positive. Sepsis education (pathophysiology, early identification, treatment) was implemented on all nursing units throughout the medical center. PRACTICE INNOVATION OUTCOMES: Before implementing the screen, there was no systematic approach to identify and treat patients with sepsis. The automatic sepsis screening tool has been welcomed by nursing staff as an efficient way to aid the early identification of patients with sepsis. The screen requires minimal data entry by the RN since data are pulled from other sources and the screen provides immediate feedback describing the patientÆs risk. In addition, electronic entry allows for tracking and aggregating data elements for ongoing analysis. In the initial 7 months of implementation of the screening tool, 163 of 6570 patients across the medical center (2.5%) screened positive. Mortality rates decreased after implementation: pre: 2005 121/310 (39%), 2006 103/280 (37%) and post: 2007 65/211 (2005 vs 2007 p = .06; 2006 vs 2007 NS), and the number of patients identified in 2007 is projected to exceed previous years by 17% - 29%. CONCLUSIONS: Implementation of evidenced-based practice guidelines for sepsis requires a simple system for early identification of patients at risk. Using technology to assist clinicians to recognize sepsis early is an important step to early implementation of treatments that can have a direct effect on mortality. Recommendations for future actions include further study and data analysis to evaluate the sensitivity and specificity of the sepsis screen elements in various patient populations, and consideration of automatic paging to the STAT RN on the Rapid Response Team for occurrences of positive sepsis screens.en_US
dc.date.available2011-10-27T15:32:30Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T15:32:30Z-
dc.conference.date2008en_US
dc.conference.nameANCC Magnet Practice Innovationsen_US
dc.conference.hostAmerican Nurses Credentialing Centeren_US
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 for further details regarding this item.-
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