"Sepsis Screening" Improving Survival of Septic Patients through Early Identification

2.50
Hdl Handle:
http://hdl.handle.net/10755/344148
Category:
Abstract
Type:
Poster
Title:
"Sepsis Screening" Improving Survival of Septic Patients through Early Identification
Author(s):
Galloway, Margaret; Arviso-Green, Rosemary; Ramming, Scott
Lead Author STTI Affiliation:
Non-member
Author Details:
Margaret Galloway, BSN, RN, CEN, eccmlg@msj.org; Rosemary Arviso-Green, MBA, RN; Scott Ramming, MD, FACEP, FAAEM
Abstract:
Evidence-based Practice Abstract Purpose: Baseline mortality rates of severe sepsis and septic shock nationwide are 25-50%. Early implementation of known strategies for the identification and treatment of severe sepsis has been shown to significantly reduce mortality rates by 15-20%. The purpose of this project is to design a screening tool to effectively identify severely septic and septic shock patients and decrease mortality by 20%. Design: This project was designed to optimize quality assurance by expediting identification of septic patients. Our screening tool was designed to capture patients waiting in triage. Identifying these patients as potentially septic early, we can implement testing that would have been delayed until they were assigned a room in the Emergency Department. Setting: This study was conducted in a 61 bed, level II trauma center with greater than 100,000 visits a year. Participants/Subjects: All patients in the emergency department were screened. Excluding patients less than eighteen years of age and those designated as a "Code Trauma" or "Trauma Alert". Methods: Implementation strategies were designed to adhere to bundle recommendations. These recommendations include: Measure lactate level, obtain blood cultures prior to antibiotic administration, administer broad spectrum antibiotics within one hour of order entry, and to administer 30ml/kg crystalloids within three hours of arrival to the Emergency Department. To rapidly identify these patients and to obtain bundle compliance we have implemented three screening tools. Two tools were employed from our current charting system and one tool designed by our department. Our screening tool screens patients exclusively in triage. If the patient meets criteria, a CBC, CMP, Lactate, and UA are automatically ordered. If their lactate is elevated, their acuity is increased and they are immediately assigned a room for treatment. This tool identifies patients early and prevents a decline of condition while waiting in triage. We have also implemented a standardized power plan for concurrent use in ICU and Emergency Department. Results/Outcomes: Sepsis screening was implemented on December 4th 2013. Prior to the screening tool and power plan initial bundle compliance was 0%. Since implementing the severe sepsis screening tool and power plan bundle recommendations, data shows 40% compliance with all aspects of the bundle. Baseline time from order entry to antibiotic was 2.7 hours. Current data shows mean time of order to administration of antibiotic at 0.67 hours. In the first month of education about the benefits of rapidly administering antibiotics after blood cultures we have decreased our administration time by more than 2 hours. Implications: Evidence based research suggests early implementation of known strategies for the identification and treatment of severe sepsis will reduce mortality by 15-20%. Based on the improvements in time to antibiotic and drastic increase in bundle compliance we predict mortality will decrease. Four quarters of data will be reviewed for the relationship between early treatment and identification of sepsis and decreased mortality.
Keywords:
Sepsis Screening; Improving Sepsis Survival
Repository Posting Date:
4-Feb-2015
Date of Publication:
4-Feb-2015
Conference Date:
2014
Conference Name:
2014 ENA Annual Conference
Conference Host:
Emergency Nurses Association
Conference Location:
Indianapolis, Indiana, U.S.A.
Description:
2014 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at the Indiana 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.typePosteren_GB
dc.title"Sepsis Screening" Improving Survival of Septic Patients through Early Identificationen_GB
dc.contributor.authorGalloway, Margareten_GB
dc.contributor.authorArviso-Green, Rosemaryen_GB
dc.contributor.authorRamming, Scotten_GB
dc.contributor.departmentNon-memberen_GB
dc.author.detailsMargaret Galloway, BSN, RN, CEN, eccmlg@msj.org; Rosemary Arviso-Green, MBA, RN; Scott Ramming, MD, FACEP, FAAEMen_GB
dc.identifier.urihttp://hdl.handle.net/10755/344148-
dc.description.abstractEvidence-based Practice Abstract Purpose: Baseline mortality rates of severe sepsis and septic shock nationwide are 25-50%. Early implementation of known strategies for the identification and treatment of severe sepsis has been shown to significantly reduce mortality rates by 15-20%. The purpose of this project is to design a screening tool to effectively identify severely septic and septic shock patients and decrease mortality by 20%. Design: This project was designed to optimize quality assurance by expediting identification of septic patients. Our screening tool was designed to capture patients waiting in triage. Identifying these patients as potentially septic early, we can implement testing that would have been delayed until they were assigned a room in the Emergency Department. Setting: This study was conducted in a 61 bed, level II trauma center with greater than 100,000 visits a year. Participants/Subjects: All patients in the emergency department were screened. Excluding patients less than eighteen years of age and those designated as a "Code Trauma" or "Trauma Alert". Methods: Implementation strategies were designed to adhere to bundle recommendations. These recommendations include: Measure lactate level, obtain blood cultures prior to antibiotic administration, administer broad spectrum antibiotics within one hour of order entry, and to administer 30ml/kg crystalloids within three hours of arrival to the Emergency Department. To rapidly identify these patients and to obtain bundle compliance we have implemented three screening tools. Two tools were employed from our current charting system and one tool designed by our department. Our screening tool screens patients exclusively in triage. If the patient meets criteria, a CBC, CMP, Lactate, and UA are automatically ordered. If their lactate is elevated, their acuity is increased and they are immediately assigned a room for treatment. This tool identifies patients early and prevents a decline of condition while waiting in triage. We have also implemented a standardized power plan for concurrent use in ICU and Emergency Department. Results/Outcomes: Sepsis screening was implemented on December 4th 2013. Prior to the screening tool and power plan initial bundle compliance was 0%. Since implementing the severe sepsis screening tool and power plan bundle recommendations, data shows 40% compliance with all aspects of the bundle. Baseline time from order entry to antibiotic was 2.7 hours. Current data shows mean time of order to administration of antibiotic at 0.67 hours. In the first month of education about the benefits of rapidly administering antibiotics after blood cultures we have decreased our administration time by more than 2 hours. Implications: Evidence based research suggests early implementation of known strategies for the identification and treatment of severe sepsis will reduce mortality by 15-20%. Based on the improvements in time to antibiotic and drastic increase in bundle compliance we predict mortality will decrease. Four quarters of data will be reviewed for the relationship between early treatment and identification of sepsis and decreased mortality.en_GB
dc.subjectSepsis Screeningen_GB
dc.subjectImproving Sepsis Survivalen_GB
dc.date.available2015-02-04T11:27:22Z-
dc.date.issued2015-02-04-
dc.date.accessioned2015-02-04T11:27:22Z-
dc.conference.date2014en_GB
dc.conference.name2014 ENA Annual Conferenceen_GB
dc.conference.hostEmergency Nurses Associationen_GB
dc.conference.locationIndianapolis, Indiana, U.S.A.en_GB
dc.description2014 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at the Indiana 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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