Sepsis Mortality Reduction Project at Contra Costa Regional Medical Center & Health Center

2.50
Hdl Handle:
http://hdl.handle.net/10755/335473
Category:
Full-text
Type:
Presentation
Title:
Sepsis Mortality Reduction Project at Contra Costa Regional Medical Center & Health Center
Author(s):
Wan, Lai Ping Atalanta
Lead Author STTI Affiliation:
Alpha Eta
Author Details:
Lai Ping Atalanta Wan, MS, RN, CNS, CCRN, laiping.wan@hsd.cccounty.us
Abstract:
Session presented on Friday, July 25, 2014: Abstract Title: Sepsis Mortality Reduction Project at Contra Costa Regional Medical Center & Health Center. Authors: Atalanta Wan, MS, RN, Kimberly Hauer, RN, Ira-Beda Sabio, RN. Why Is This Important? Sepsis is a complex syndrome that is difficult to define, diagnose, and treat. It is a range of clinical conditions caused by the body's systemic response to an infection. If it develops into severe sepsis complicated with single or multiple organ dysfunction or failure, sepsis may lead to death. Sepsis is a common leading cause of death in the United States, and the mortality rate of severe sepsis ranges from 28% to 50% (Daniels, 2011). Improvement Journey: The 'Stomp Out Sepsis' (SOS) initiative began at Contra Costa Regional Medical Center (CCRMC) in October 2009. Its roll-out began in January 2010 with refinements continuing to this day. A multidisciplinary team involves physicians, nurses, lab personnel, infection control practitioners, pharmacist, and other drawn from throughout the hospital to implement the SOS project. The team utilized classic quality management techniques, such as standardized work (checklists and standard sepsis order sets), inter-departmental collaboration, staff education, team building, frontline nurse champions, and close monitoring to ensure continuous improvement towards our goals. What Are We Trying to Accomplish? By June 30, 2015, we will reduce mortality due to sepsis at CCRMC at least 15% by increasing early sepsis recognition and increased compliance with Early Goal Directed Therapy (EGDT) guidelines (Dellinger et al., 2013). Achieve 95% compliance in the use of the severe sepsis screening tool with all patients, and achieve at least 85% compliance in the use of the EGDT bundle. Target Population Inclusions: All patients age 18 years and older presenting to the emergency department (ED) or inpatients on acute care units. Exclusions: Inpatients on the hospital skilled nursing facility(SNF) units, OB patients, patients transferred to ICU with severe sepsis or septic shock, patients who are 'Do not Resuscitation' (DNR), 'Do not Intubation'(DNI), comfort care or palliative care on admission or ordered within 24 hours, and patients who signed out 'Against Medical Advice' (AMA), left the ED without being seen (LWBS), or who refuse care. Results: Up to date, September 2013, we reduce mortality due to sepsis at CCRMC to less than 15%, and achieve above 50% compliance with the EDGT bundle (lactate, blood culture, antibiotic, fluid bolus) within the first hour. Lessons Learned/Challenges: Development and implementation of sepsis screening tool. Implementation of ISTAT lactate for ED patients. Institution of nurse stat lactate order protocol. Physicians reluctant to give fluid bolus when patients have multiple comorbidities. Blood collection supplies not easily accessible for inpatient nurses to draw STAT lactates. Confusion regarding which sepsis order set to use.
Keywords:
sepsis bundle; evidence-based practice; sepsis
Repository Posting Date:
17-Nov-2014
Date of Publication:
11 ; 11
Other Identifiers:
INRC14PST18
Conference Date:
2014
Conference Name:
25th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Hong Kong
Description:
International Nursing Research Congress, 2014 Theme: Engaging Colleagues: Improving Global Health Outcomes. Held at the Hong Kong Convention and Exhibition Centre, Wanchai, Hong Kong

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.language.isoenen
dc.type.categoryFull-texten
dc.typePresentationen
dc.titleSepsis Mortality Reduction Project at Contra Costa Regional Medical Center & Health Centeren
dc.contributor.authorWan, Lai Ping Atalantaen
dc.contributor.departmentAlpha Etaen
dc.author.detailsLai Ping Atalanta Wan, MS, RN, CNS, CCRN, laiping.wan@hsd.cccounty.usen
dc.identifier.urihttp://hdl.handle.net/10755/335473-
dc.description.abstractSession presented on Friday, July 25, 2014: Abstract Title: Sepsis Mortality Reduction Project at Contra Costa Regional Medical Center & Health Center. Authors: Atalanta Wan, MS, RN, Kimberly Hauer, RN, Ira-Beda Sabio, RN. Why Is This Important? Sepsis is a complex syndrome that is difficult to define, diagnose, and treat. It is a range of clinical conditions caused by the body's systemic response to an infection. If it develops into severe sepsis complicated with single or multiple organ dysfunction or failure, sepsis may lead to death. Sepsis is a common leading cause of death in the United States, and the mortality rate of severe sepsis ranges from 28% to 50% (Daniels, 2011). Improvement Journey: The 'Stomp Out Sepsis' (SOS) initiative began at Contra Costa Regional Medical Center (CCRMC) in October 2009. Its roll-out began in January 2010 with refinements continuing to this day. A multidisciplinary team involves physicians, nurses, lab personnel, infection control practitioners, pharmacist, and other drawn from throughout the hospital to implement the SOS project. The team utilized classic quality management techniques, such as standardized work (checklists and standard sepsis order sets), inter-departmental collaboration, staff education, team building, frontline nurse champions, and close monitoring to ensure continuous improvement towards our goals. What Are We Trying to Accomplish? By June 30, 2015, we will reduce mortality due to sepsis at CCRMC at least 15% by increasing early sepsis recognition and increased compliance with Early Goal Directed Therapy (EGDT) guidelines (Dellinger et al., 2013). Achieve 95% compliance in the use of the severe sepsis screening tool with all patients, and achieve at least 85% compliance in the use of the EGDT bundle. Target Population Inclusions: All patients age 18 years and older presenting to the emergency department (ED) or inpatients on acute care units. Exclusions: Inpatients on the hospital skilled nursing facility(SNF) units, OB patients, patients transferred to ICU with severe sepsis or septic shock, patients who are 'Do not Resuscitation' (DNR), 'Do not Intubation'(DNI), comfort care or palliative care on admission or ordered within 24 hours, and patients who signed out 'Against Medical Advice' (AMA), left the ED without being seen (LWBS), or who refuse care. Results: Up to date, September 2013, we reduce mortality due to sepsis at CCRMC to less than 15%, and achieve above 50% compliance with the EDGT bundle (lactate, blood culture, antibiotic, fluid bolus) within the first hour. Lessons Learned/Challenges: Development and implementation of sepsis screening tool. Implementation of ISTAT lactate for ED patients. Institution of nurse stat lactate order protocol. Physicians reluctant to give fluid bolus when patients have multiple comorbidities. Blood collection supplies not easily accessible for inpatient nurses to draw STAT lactates. Confusion regarding which sepsis order set to use.en
dc.subjectsepsis bundleen
dc.subjectevidence-based practiceen
dc.subjectsepsisen
dc.date.available2014-11-17T13:53:19Z-
dc.date.issued11/17/2014-
dc.date.issued11/17/2014en
dc.date.accessioned2014-11-17T13:53:19Z-
dc.conference.date2014en
dc.conference.name25th International Nursing Research Congressen
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen
dc.conference.locationHong Kongen
dc.descriptionInternational Nursing Research Congress, 2014 Theme: Engaging Colleagues: Improving Global Health Outcomes. Held at the Hong Kong Convention and Exhibition Centre, Wanchai, Hong Kongen
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