Survivor: Sepsis Edition Early Identification and Treatment Achieves Positive Outcomes

2.50
Hdl Handle:
http://hdl.handle.net/10755/306552
Category:
Abstract
Type:
Poster
Title:
Survivor: Sepsis Edition Early Identification and Treatment Achieves Positive Outcomes
Author(s):
Bigowsky, Mary; Gluckner, Rhonda
Lead Author STTI Affiliation:
Non-member
Author Details:
Mary Bigowsky, MSN, RN, NEA-BC, mary_bigowsky@hmis.org; Rhonda Gluckner, BSN, RN
Abstract:

Evidence-based Practice Abstract

Purpose: Sepsis is a condition that is difficult to identify and treat, and has a mortality rate between 28-50%. The purpose of this project was to develop and implement a multidisciplinary program aimed at early identification of sepsis, prompt implementation of evidence-based treatment and reduction in sepsis mortality and length of stay (LOS).

Design: Multidisciplinary performance improvement project designed to improve the process of providing evidence-based services to meet the needs of patients and stakeholders.

Setting: A 560 bed, three-time designated Magnet, urban, level one trauma tertiary care center with a 39 bed emergency department (ED) averaging more than 41,000 visits per year.

Subjects: Patients 18 and over identified as meeting criteria for the risk of sepsis, as identified by the triage nurse assessment. This project did not include any patients whom were not at risk for sepsis or did not meet sepsis criteria.

Methods: An interdisciplinary sepsis team was charged with developing the structures and processes necessary to improve the management of sepsis for patients presenting to the ED. Policies and procedures and a “sepsis bundle” of key actions were developed based on evidence based guidelines and review of best practices. Early on, the team recognized the need for a RN, dedicated, sepsis coordinator. The sepsis coordinator is responsible for monitoring and evaluating compliance with standards of care for sepsis patients. The sepsis coordinator played a significant role in educating nurses and physicians on the sepsis “bundle” and best practices, and in developing tools to facilitate compliance with best practices. The sepsis coordinator monitors compliance to standards monthly and reports results to Performance Improvement Committee, Shared Governance Council meetings and ED Operations Committee. The coordinator also recognizes physicians and nurses through public acknowledgement when they are 100% compliant with the “sepsis bundle."

Results/Outcomes: Baseline data for severe sepsis and septic shock reflected a mortality rate of 19.8% and an average LOS of 13.7 days. Following the implementation of the “sepsis bundle” and sepsis coordinator role, the mortality for severe sepsis and septic shock decreased to 13.7% and average LOS decreased to 8.8 days over a 2 year period (2010-2012YTD). Compliance with the sepsis bundle increased more than 80% from the initial 35% during that same time period.

Implications: A sepsis coordinator can effectively engage the ED staff to ensure evidence-based standards for the management of sepsis are implemented in the ED. The implementation of the sepsis coordinator demonstrated reductions in mortality and length of stay, as well as increased compliance with evidence based interventions. Collaboration among the sepsis coordinator, medical and nursing staff, continuous education, and consistent monitoring of compliance to standards are key to improving outcomes for sepsis patients presenting to the ED.

Keywords:
Sepsis
Repository Posting Date:
9-Dec-2013
Date of Publication:
9-Dec-2013
Conference Date:
2013
Conference Name:
2013 ENA Leadership Conference
Conference Host:
Emergency Nurses Association
Conference Location:
Ft. Lauderdale, Florida, USA
Description:
2013 ENA Leadership Conference Theme: Shape the Future. Held at the Greater Fort Lauderdale Broward County Convention 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.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePosteren_GB
dc.titleSurvivor: Sepsis Edition Early Identification and Treatment Achieves Positive Outcomesen_GB
dc.contributor.authorBigowsky, Maryen_GB
dc.contributor.authorGluckner, Rhondaen_GB
dc.contributor.departmentNon-memberen_GB
dc.author.detailsMary Bigowsky, MSN, RN, NEA-BC, mary_bigowsky@hmis.org; Rhonda Gluckner, BSN, RNen_GB
dc.identifier.urihttp://hdl.handle.net/10755/306552-
dc.description.abstract<p>Evidence-based Practice Abstract</p><p>Purpose: Sepsis is a condition that is difficult to identify and treat, and has a mortality rate between 28-50%. The purpose of this project was to develop and implement a multidisciplinary program aimed at early identification of sepsis, prompt implementation of evidence-based treatment and reduction in sepsis mortality and length of stay (LOS).</p><p>Design: Multidisciplinary performance improvement project designed to improve the process of providing evidence-based services to meet the needs of patients and stakeholders.</p><p>Setting: A 560 bed, three-time designated Magnet, urban, level one trauma tertiary care center with a 39 bed emergency department (ED) averaging more than 41,000 visits per year.</p><p>Subjects: Patients 18 and over identified as meeting criteria for the risk of sepsis, as identified by the triage nurse assessment. This project did not include any patients whom were not at risk for sepsis or did not meet sepsis criteria.</p><p>Methods: An interdisciplinary sepsis team was charged with developing the structures and processes necessary to improve the management of sepsis for patients presenting to the ED. Policies and procedures and a “sepsis bundle” of key actions were developed based on evidence based guidelines and review of best practices. Early on, the team recognized the need for a RN, dedicated, sepsis coordinator. The sepsis coordinator is responsible for monitoring and evaluating compliance with standards of care for sepsis patients. The sepsis coordinator played a significant role in educating nurses and physicians on the sepsis “bundle” and best practices, and in developing tools to facilitate compliance with best practices. The sepsis coordinator monitors compliance to standards monthly and reports results to Performance Improvement Committee, Shared Governance Council meetings and ED Operations Committee. The coordinator also recognizes physicians and nurses through public acknowledgement when they are 100% compliant with the “sepsis bundle."</p><p>Results/Outcomes: Baseline data for severe sepsis and septic shock reflected a mortality rate of 19.8% and an average LOS of 13.7 days. Following the implementation of the “sepsis bundle” and sepsis coordinator role, the mortality for severe sepsis and septic shock decreased to 13.7% and average LOS decreased to 8.8 days over a 2 year period (2010-2012YTD). Compliance with the sepsis bundle increased more than 80% from the initial 35% during that same time period.</p><p>Implications: A sepsis coordinator can effectively engage the ED staff to ensure evidence-based standards for the management of sepsis are implemented in the ED. The implementation of the sepsis coordinator demonstrated reductions in mortality and length of stay, as well as increased compliance with evidence based interventions. Collaboration among the sepsis coordinator, medical and nursing staff, continuous education, and consistent monitoring of compliance to standards are key to improving outcomes for sepsis patients presenting to the ED.</p>en_GB
dc.subjectSepsisen_GB
dc.date.available2013-12-09T16:59:39Z-
dc.date.issued2013-12-09-
dc.date.accessioned2013-12-09T16:59:39Z-
dc.conference.date2013en_GB
dc.conference.name2013 ENA Leadership Conferenceen_GB
dc.conference.hostEmergency Nurses Associationen_GB
dc.conference.locationFt. Lauderdale, Florida, USAen_GB
dc.description2013 ENA Leadership Conference Theme: Shape the Future. Held at the Greater Fort Lauderdale Broward County Convention Centeren_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.en_GB
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