10.50
Hdl Handle:
http://hdl.handle.net/10755/324164
Category:
Abstract
Type:
Presentation
Title:
Sepsis Alert: An Emergency Team Approach to Surviving Sepsis
Author(s):
Bigowsky, Mary
Author Details:
Mary Bigowsky, MSN, RN, NEA-BC, email: mary_bigowsky@hmis.org
Abstract:
Evidence-based Practice Abstract Purpose: The Emergency Department serves an important role in the early identification and treatment of sepsis. Revisions to the Surviving Sepsis Campaign guidelines require the administration of adequate fluid resuscitation and administration of intravenous antibiotics within one hour of identification of severe sepsis or septic shock. This can be very challenging for a busy emergency department. The purpose of this project was to develop and implement a multidisciplinary sepsis team in the Emergency Department (ED) aimed at early identification of sepsis and prompt implementation of evidence-based treatment. Design: Multidisciplinary performance improvement project. Setting: Two acute care Magnet hospitals including a Level 1 trauma center and a 120 bed community hospital located in northeast Ohio. Emergency visits at each facility exceeded 43,000 visits annually. Subjects: Patients 18 years and older identified as meeting criteria for the risk of sepsis as identified by the triage nurse assessment. Methods: The multidisciplinary team developed a nurse-driven “Sepsis Alert” to identify and treat sepsis patients who present to the Emergency Department (ED) with sepsis criteria including SIRS (systemic inflammatory response) and signs or symptoms of a potential infection. Utilizing process flow diagrams and performance improvement tools, the team redesigned the intake process and identified key roles for team members. The triage RN screens for sepsis and calls an internal “Sepsis Alert” when identifying a potential sepsis patient. A team of two nurses, an emergency medicine physician, a clinical pharmacist and emergency assistant arrive at the patient bedside, provide a more in-depth assessment and implement a “sepsis bundle” of key actions. The sepsis bundle is based on the Sepsis Alliance evidence-based practice guidelines and review of best practices for sepsis treatment. Outcomes: Following the implementation of the ED “Sepsis Alert,” compliance with antibiotic administration within one hour increased from 32.7% to 59.8% at the trauma center and from 54.4% to 84.2% at the community hospital within 6 months of “Sepsis Alert” implementation. In addition, fluid resuscitation compliance increased from 45.8% to 73.8% and from 56.2% to 70% at the trauma center and community hospital respectfully. Compliance with the complete sepsis bundle also increased from 45% to 73% at the trauma center and 36.4% to 70% at the community hospital. Implementation of the Sepsis Alert saved lives through prompt identification and implementation of evidence based practice. Implications: A “Sepsis Alert” can effectively engage the ED staff to ensure compliance with evidence-based standards for the management of sepsis. A “Sepsis Alert” is effective in both trauma centers and community hospitals. The implementation of a nurse-driven “Sepsis Alert” demonstrated increased compliance in antibiotic administration and fluid resuscitation within a narrow timeframe of one hour. Collaboration among the sepsis coordinator, emergency medicine, clinical pharmacy and the nursing staff as well as continuous education and consistent monitoring of compliance to standards are essential to improving outcomes for sepsis patients presenting to the ED.
Keywords:
Surviving Sepsis; Sepsis
Repository Posting Date:
4-Aug-2014
Date of Publication:
4-Aug-2014
Conference Date:
2014
Conference Name:
2014 ENA Leadership Conference
Conference Host:
Emergency Nurses Association
Conference Location:
Phoenix, Arizona USA
Description:
2014 ENA Leadership Conference Theme: Safe Practice, Safe Care. Held at the Phoenix 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. 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.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleSepsis Alert: An Emergency Team Approach to Surviving Sepsisen_GB
dc.contributor.authorBigowsky, Maryen_GB
dc.author.detailsMary Bigowsky, MSN, RN, NEA-BC, email: mary_bigowsky@hmis.orgen_GB
dc.identifier.urihttp://hdl.handle.net/10755/324164-
dc.description.abstractEvidence-based Practice Abstract Purpose: The Emergency Department serves an important role in the early identification and treatment of sepsis. Revisions to the Surviving Sepsis Campaign guidelines require the administration of adequate fluid resuscitation and administration of intravenous antibiotics within one hour of identification of severe sepsis or septic shock. This can be very challenging for a busy emergency department. The purpose of this project was to develop and implement a multidisciplinary sepsis team in the Emergency Department (ED) aimed at early identification of sepsis and prompt implementation of evidence-based treatment. Design: Multidisciplinary performance improvement project. Setting: Two acute care Magnet hospitals including a Level 1 trauma center and a 120 bed community hospital located in northeast Ohio. Emergency visits at each facility exceeded 43,000 visits annually. Subjects: Patients 18 years and older identified as meeting criteria for the risk of sepsis as identified by the triage nurse assessment. Methods: The multidisciplinary team developed a nurse-driven “Sepsis Alert” to identify and treat sepsis patients who present to the Emergency Department (ED) with sepsis criteria including SIRS (systemic inflammatory response) and signs or symptoms of a potential infection. Utilizing process flow diagrams and performance improvement tools, the team redesigned the intake process and identified key roles for team members. The triage RN screens for sepsis and calls an internal “Sepsis Alert” when identifying a potential sepsis patient. A team of two nurses, an emergency medicine physician, a clinical pharmacist and emergency assistant arrive at the patient bedside, provide a more in-depth assessment and implement a “sepsis bundle” of key actions. The sepsis bundle is based on the Sepsis Alliance evidence-based practice guidelines and review of best practices for sepsis treatment. Outcomes: Following the implementation of the ED “Sepsis Alert,” compliance with antibiotic administration within one hour increased from 32.7% to 59.8% at the trauma center and from 54.4% to 84.2% at the community hospital within 6 months of “Sepsis Alert” implementation. In addition, fluid resuscitation compliance increased from 45.8% to 73.8% and from 56.2% to 70% at the trauma center and community hospital respectfully. Compliance with the complete sepsis bundle also increased from 45% to 73% at the trauma center and 36.4% to 70% at the community hospital. Implementation of the Sepsis Alert saved lives through prompt identification and implementation of evidence based practice. Implications: A “Sepsis Alert” can effectively engage the ED staff to ensure compliance with evidence-based standards for the management of sepsis. A “Sepsis Alert” is effective in both trauma centers and community hospitals. The implementation of a nurse-driven “Sepsis Alert” demonstrated increased compliance in antibiotic administration and fluid resuscitation within a narrow timeframe of one hour. Collaboration among the sepsis coordinator, emergency medicine, clinical pharmacy and the nursing staff as well as continuous education and consistent monitoring of compliance to standards are essential to improving outcomes for sepsis patients presenting to the ED.en_GB
dc.subjectSurviving Sepsisen_GB
dc.subjectSepsisen_GB
dc.date.available2014-08-04T13:28:40Z-
dc.date.issued2014-08-04-
dc.date.accessioned2014-08-04T13:28:40Z-
dc.conference.date2014en_GB
dc.conference.name2014 ENA Leadership Conferenceen_GB
dc.conference.hostEmergency Nurses Associationen_GB
dc.conference.locationPhoenix, Arizona USAen_GB
dc.description2014 ENA Leadership Conference Theme: Safe Practice, Safe Care. Held at the Phoenix 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. 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.en_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.