2.50
Hdl Handle:
http://hdl.handle.net/10755/324165
Category:
Abstract
Type:
Presentation
Title:
Reducing Sepsis Mortality in a Large Health Care System
Author(s):
Powell, Kristine
Author Details:
Kristine Powell, MSN, RN, CEN, NEA-BC, email: krisp@baylorhealth.edu
Abstract:
Evidence-based Practice Abstract Purpose: In FY2008, the Health Care System reported a Hospital Standardized Mortality Ratio (HSMR-TX09) of 1.15 which represented 50 more observed deaths (n=378) from sepsis than what was expected (n=328). The Emergency Department (ED) Council made up of nursing, physician, and executive leadership began implementing system-wide planned initiatives to reduce sepsis mortality. Design: The ED Council used a PDCA (Plan-Do-Check-Act) quality improvement approach to improve sepsis care across the Health Care System. Setting: This sepsis care improvement project spanned 10 acute care hospitals in the Health Care System. Participants/Subjects: The ED Council focused on improving sepsis care by implementing sepsis screening for all patients greater than or equal to 16 years old who presented to the ED and implementing a core bundle of care for those patients who screened positive for sepsis. Methods: Multiple improvement initiatives were planned and implemented across all of the Emergency Departments in the Health Care System from FY09 through FY13. The initiatives included development and implementation of a standardized screening tool in all system ED’s in September 2009 with education of all ED staff on the pathophysiology of sepsis, SIRS criteria, sepsis screening and evidence-based care based on the Surviving Sepsis Campaign. Goals for compliance with specific care processes were developed in April 2011 which included door to antibiotic time and door to completion of IVF bolus time. Beginning in April 2011, chart audits and monthly compliance reports were disseminated and reviewed each month with overall system compliance and individual facility compliance. Sepsis mortality reports were also generated and reviewed each month which included overall system and individual facility sepsis mortality. Strong support and engagement occurred at all levels including Hospital CEO’s and CNO’s, BHCS Chief Nursing Officer, Physician, and Nursing leadership. Compliance goals were included in annual performance appraisals for executive staff and ED leadership across the system. Sepsis care multidisciplinary committees were initiated at the System level and at each of the individual facilities. A multidisciplinary approach ensured involvement of all necessary disciplines including Emergency Services, Critical Care, Quality, Ancillary Services, and other disciplines. The system ED Council included sepsis care on the standing monthly meeting agenda for continued awareness and accountability. Results/Outcomes: By focusing on improved recognition and management of sepsis patients in all ED’s in the Health Care System, sepsis Mortality (HSMR-TX09) decreased from 1.15 in FY2008 (50 more deaths than expected) to 0.75 in FY2013 (169 less deaths than expected). These results were driven by improved care processes with a reduction in door to antibiotic time from an average of 125 minutes in April 2011 to 80 minutes in June 2013 and a reduction in door to IV Fluid bolus completion time from an average of 137 minutes in April 2011 to 94 minutes in June 2013. Implications: By implementing standardized screening, care, and reporting processes for sepsis across all emergency departments in the Health Care System, mortality from sepsis has reduced significantly.
Keywords:
Sepsis; Reducing Sepsis Mortality
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.titleReducing Sepsis Mortality in a Large Health Care Systemen_GB
dc.contributor.authorPowell, Kristineen_GB
dc.author.detailsKristine Powell, MSN, RN, CEN, NEA-BC, email: krisp@baylorhealth.eduen_GB
dc.identifier.urihttp://hdl.handle.net/10755/324165-
dc.description.abstractEvidence-based Practice Abstract Purpose: In FY2008, the Health Care System reported a Hospital Standardized Mortality Ratio (HSMR-TX09) of 1.15 which represented 50 more observed deaths (n=378) from sepsis than what was expected (n=328). The Emergency Department (ED) Council made up of nursing, physician, and executive leadership began implementing system-wide planned initiatives to reduce sepsis mortality. Design: The ED Council used a PDCA (Plan-Do-Check-Act) quality improvement approach to improve sepsis care across the Health Care System. Setting: This sepsis care improvement project spanned 10 acute care hospitals in the Health Care System. Participants/Subjects: The ED Council focused on improving sepsis care by implementing sepsis screening for all patients greater than or equal to 16 years old who presented to the ED and implementing a core bundle of care for those patients who screened positive for sepsis. Methods: Multiple improvement initiatives were planned and implemented across all of the Emergency Departments in the Health Care System from FY09 through FY13. The initiatives included development and implementation of a standardized screening tool in all system ED’s in September 2009 with education of all ED staff on the pathophysiology of sepsis, SIRS criteria, sepsis screening and evidence-based care based on the Surviving Sepsis Campaign. Goals for compliance with specific care processes were developed in April 2011 which included door to antibiotic time and door to completion of IVF bolus time. Beginning in April 2011, chart audits and monthly compliance reports were disseminated and reviewed each month with overall system compliance and individual facility compliance. Sepsis mortality reports were also generated and reviewed each month which included overall system and individual facility sepsis mortality. Strong support and engagement occurred at all levels including Hospital CEO’s and CNO’s, BHCS Chief Nursing Officer, Physician, and Nursing leadership. Compliance goals were included in annual performance appraisals for executive staff and ED leadership across the system. Sepsis care multidisciplinary committees were initiated at the System level and at each of the individual facilities. A multidisciplinary approach ensured involvement of all necessary disciplines including Emergency Services, Critical Care, Quality, Ancillary Services, and other disciplines. The system ED Council included sepsis care on the standing monthly meeting agenda for continued awareness and accountability. Results/Outcomes: By focusing on improved recognition and management of sepsis patients in all ED’s in the Health Care System, sepsis Mortality (HSMR-TX09) decreased from 1.15 in FY2008 (50 more deaths than expected) to 0.75 in FY2013 (169 less deaths than expected). These results were driven by improved care processes with a reduction in door to antibiotic time from an average of 125 minutes in April 2011 to 80 minutes in June 2013 and a reduction in door to IV Fluid bolus completion time from an average of 137 minutes in April 2011 to 94 minutes in June 2013. Implications: By implementing standardized screening, care, and reporting processes for sepsis across all emergency departments in the Health Care System, mortality from sepsis has reduced significantly.en_GB
dc.subjectSepsisen_GB
dc.subjectReducing Sepsis Mortalityen_GB
dc.date.available2014-08-04T13:28:41Z-
dc.date.issued2014-08-04-
dc.date.accessioned2014-08-04T13:28:41Z-
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
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