2.50
Hdl Handle:
http://hdl.handle.net/10755/344161
Category:
Abstract
Type:
Poster
Title:
Stop the Shock: Early Sepsis Screening Saves Lives
Author(s):
Boley, Nikki
Lead Author STTI Affiliation:
Non-member
Author Details:
Nikki Boley, BSN, RN, CEN, nikki.l.boley@osfhealthcare.org
Abstract:
Evidence-based Practice Abstract Purpose: Sepsis is a major cause of mortality and morbidity, which has a major impact on healthcare resources and finances. Having an early warning signs sepsis screening tool assists staff in early identification and treatment of patients with early signs of sepsis. The purpose of this project was to teach staff to identify early warning signs of sepsis and quickly initiate interventions in the emergency department. Hospital sepsis mortality rate was 15% prior to the initiation of the screening tool. The goal of the project was to decrease the overall hospital mortality rate to the 9% national benchmark. Design: This evidenced-based quality and patient safety project was a collaborative effort between the emergency department, pharmacy, laboratory services, quality and safety department, and the Critical Care Coordinator. Setting: The project was developed in a 57 bed emergency department of a Level 1 Trauma Center with 86,000 visits per year. Participants/Subjects: All patients that present to the Emergency department that are 18 years and older. Methods: The project development began with a collaboration of emergency medicine and critical care staff to design a screening tool that identifies early warning signs of sepsis in adult patients. A test of change was completed to determine sensitivity of the tool and make any needed modifications. In-seat education was provided for nursing, including sepsis disease process. The screening tool includes vital signs (heart rate, respiratory rate, temperature, and blood pressure) coupled with the chief complaint to determine a positive or negative screen. Interventions for a positive screen include: immediate physician notification, point of care lactate, complete blood count with differential, complete metabolic panel, first set of blood cultures, and one liter normal saline fluid bolus. Physician intervention includes collaboration with pharmacy to order appropriate antibiotic to be given within the first hour of patient presenting to the emergency department, with pharmacy delivering the antibiotic to the bedside. The screening tool also contains a sepsis bundle checklist for the physician that includes interventions to be completed in three and six hours. Results/Outcomes: Project went live June 1, 2013. Hospital sepsis mortality rate decreased to 11.6% by October 1, and continues to decline. The following diagnostic related groups were tracked: 870 Severe Septic Shock, 871 Less Severe Septic Shock, and 872 Sepsis with no comorbidities. All groups showed decrease in hospital length of stay in the first three months, and continue to decline. Diagnostic related group 870 baseline was 18 days with a decrease to 17.25 days. Diagnostic related group 871 baseline was 7.2 days with a decrease to 6.44 days. Diagnostic related group 872 baseline was 4.99 days with a decrease to 2.66 days. Overall sepsis bundle compliance increased from 26% to 45%. Implications: Establishing a sepsis screening tool with early interventions provides best practice, decreases mortality and morbidity rates, and decreases hospital length of stay. Use of a sepsis screening tool saves lives. Future state includes use of screening tool in pre-hospital setting, and adding to the electronic medical record.
Keywords:
Sepsis Screening; Sepsis
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.titleStop the Shock: Early Sepsis Screening Saves Livesen_GB
dc.contributor.authorBoley, Nikkien_GB
dc.contributor.departmentNon-memberen_GB
dc.author.detailsNikki Boley, BSN, RN, CEN, nikki.l.boley@osfhealthcare.orgen_GB
dc.identifier.urihttp://hdl.handle.net/10755/344161-
dc.description.abstractEvidence-based Practice Abstract Purpose: Sepsis is a major cause of mortality and morbidity, which has a major impact on healthcare resources and finances. Having an early warning signs sepsis screening tool assists staff in early identification and treatment of patients with early signs of sepsis. The purpose of this project was to teach staff to identify early warning signs of sepsis and quickly initiate interventions in the emergency department. Hospital sepsis mortality rate was 15% prior to the initiation of the screening tool. The goal of the project was to decrease the overall hospital mortality rate to the 9% national benchmark. Design: This evidenced-based quality and patient safety project was a collaborative effort between the emergency department, pharmacy, laboratory services, quality and safety department, and the Critical Care Coordinator. Setting: The project was developed in a 57 bed emergency department of a Level 1 Trauma Center with 86,000 visits per year. Participants/Subjects: All patients that present to the Emergency department that are 18 years and older. Methods: The project development began with a collaboration of emergency medicine and critical care staff to design a screening tool that identifies early warning signs of sepsis in adult patients. A test of change was completed to determine sensitivity of the tool and make any needed modifications. In-seat education was provided for nursing, including sepsis disease process. The screening tool includes vital signs (heart rate, respiratory rate, temperature, and blood pressure) coupled with the chief complaint to determine a positive or negative screen. Interventions for a positive screen include: immediate physician notification, point of care lactate, complete blood count with differential, complete metabolic panel, first set of blood cultures, and one liter normal saline fluid bolus. Physician intervention includes collaboration with pharmacy to order appropriate antibiotic to be given within the first hour of patient presenting to the emergency department, with pharmacy delivering the antibiotic to the bedside. The screening tool also contains a sepsis bundle checklist for the physician that includes interventions to be completed in three and six hours. Results/Outcomes: Project went live June 1, 2013. Hospital sepsis mortality rate decreased to 11.6% by October 1, and continues to decline. The following diagnostic related groups were tracked: 870 Severe Septic Shock, 871 Less Severe Septic Shock, and 872 Sepsis with no comorbidities. All groups showed decrease in hospital length of stay in the first three months, and continue to decline. Diagnostic related group 870 baseline was 18 days with a decrease to 17.25 days. Diagnostic related group 871 baseline was 7.2 days with a decrease to 6.44 days. Diagnostic related group 872 baseline was 4.99 days with a decrease to 2.66 days. Overall sepsis bundle compliance increased from 26% to 45%. Implications: Establishing a sepsis screening tool with early interventions provides best practice, decreases mortality and morbidity rates, and decreases hospital length of stay. Use of a sepsis screening tool saves lives. Future state includes use of screening tool in pre-hospital setting, and adding to the electronic medical record.en_GB
dc.subjectSepsis Screeningen_GB
dc.subjectSepsisen_GB
dc.date.available2015-02-04T11:27:35Z-
dc.date.issued2015-02-04-
dc.date.accessioned2015-02-04T11:27:35Z-
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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