Nurse driven protocols to promptly identify and treat patients at risk for sepsis in the Emergency Department

2.50
Hdl Handle:
http://hdl.handle.net/10755/308343
Category:
Abstract
Type:
Presentation
Title:
Nurse driven protocols to promptly identify and treat patients at risk for sepsis in the Emergency Department
Author(s):
Dobrasz, Gina
Lead Author STTI Affiliation:
N/A
Author Details:
Gina Dobrasz, MS, RN, Gina.Dobrasz@choa.org
Abstract:

Poster presented on: Saturday, November 16, 2013, Sunday, November 17, 2013

Infection is a frequent complication experienced by many pediatric  patients with potentially life threatening consequences. The need for prompt assessment and early intervention for infection is widely recognized by Emergency Department (ED) staff as best practice, however, the average length of time to antibiotic administration varies widely in published studies.  An interdisciplinary quality improvement initiative including physician, nursing, and pharmacy leaders was created to streamline the identification and treatment for these high-risk populations.  This project was conducted at two EDs in a pediatric healthcare system with 520 beds who see approximately 154,000 patients annually.  Records from all patients with fever and a known history of cancer and sickle cell disease who presented to the EDs were included in the retrospective review.  Exclusion criteria included patients in known remission, those with prior antibiotic therapy at another facility, congenital neutropenia, or parental concern or objection to treatment.  A retrospective medical record review of patients treated (5,559) from September 2008 until March 2013 was conducted to evaluate the impact of this evidence based practice change to streamline the "door to drug" process.  The average length of time until antibiotic administration, nurses' compliance initiating the protocol, and ED length of stay were determined.  Both ED's average time for drug administration dropped from 128 minutes to 50 minutes for oncology patients and from 78 to 44 minutes for sickle cell patients. Both campuses also improved their protocol compliance and decreased the overall ED length of stay.  This quality initiative has direct application for all ED leaders who treat pediatric patients. High-risk patients can benefit from a streamlined nurse initiated process that decreases negative consequences of fever. Collaboration by interdisciplinary leadership within the healthcare facility as well as key stakeholder buy-in is imperative to achieve a process that may lead to decreased hospital stay and reduced systemic infection or mortality for these vulnerable patients.
Keywords:
Protocol; Fever; Sepsis
Repository Posting Date:
19-Dec-2013
Date of Publication:
19-Dec-2013
Conference Date:
2013
Conference Name:
42nd Biennial Convention
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Indianapolis, Indiana, USA
Description:
42nd Biennial Convention 2013 Theme: Give Back to Move Forward. Held at the JW Marriott
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.typePresentationen_GB
dc.titleNurse driven protocols to promptly identify and treat patients at risk for sepsis in the Emergency Departmenten_GB
dc.contributor.authorDobrasz, Ginaen_GB
dc.contributor.departmentN/Aen_GB
dc.author.detailsGina Dobrasz, MS, RN, Gina.Dobrasz@choa.orgen_GB
dc.identifier.urihttp://hdl.handle.net/10755/308343-
dc.description.abstract<p>Poster presented on: Saturday, November 16, 2013, Sunday, November 17, 2013</p>Infection is a frequent complication experienced by many pediatric  patients with potentially life threatening consequences. The need for prompt assessment and early intervention for infection is widely recognized by Emergency Department (ED) staff as best practice, however, the average length of time to antibiotic administration varies widely in published studies.  An interdisciplinary quality improvement initiative including physician, nursing, and pharmacy leaders was created to streamline the identification and treatment for these high-risk populations.  This project was conducted at two EDs in a pediatric healthcare system with 520 beds who see approximately 154,000 patients annually.  Records from all patients with fever and a known history of cancer and sickle cell disease who presented to the EDs were included in the retrospective review.  Exclusion criteria included patients in known remission, those with prior antibiotic therapy at another facility, congenital neutropenia, or parental concern or objection to treatment.  A retrospective medical record review of patients treated (5,559) from September 2008 until March 2013 was conducted to evaluate the impact of this evidence based practice change to streamline the "door to drug" process.  The average length of time until antibiotic administration, nurses' compliance initiating the protocol, and ED length of stay were determined.  Both ED's average time for drug administration dropped from 128 minutes to 50 minutes for oncology patients and from 78 to 44 minutes for sickle cell patients. Both campuses also improved their protocol compliance and decreased the overall ED length of stay.  This quality initiative has direct application for all ED leaders who treat pediatric patients. High-risk patients can benefit from a streamlined nurse initiated process that decreases negative consequences of fever. Collaboration by interdisciplinary leadership within the healthcare facility as well as key stakeholder buy-in is imperative to achieve a process that may lead to decreased hospital stay and reduced systemic infection or mortality for these vulnerable patients.en_GB
dc.subjectProtocolen_GB
dc.subjectFeveren_GB
dc.subjectSepsisen_GB
dc.date.available2013-12-19T17:30:05Z-
dc.date.issued2013-12-19-
dc.date.accessioned2013-12-19T17:30:05Z-
dc.conference.date2013en_GB
dc.conference.name42nd Biennial Conventionen_GB
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen_GB
dc.conference.locationIndianapolis, Indiana, USAen_GB
dc.description42nd Biennial Convention 2013 Theme: Give Back to Move Forward. Held at the JW Marriotten_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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