CS91 - Joining Forces, ICU and Acute Care Nurses Avert Disaster through Early Sepsis Recognition and Treatment
Primary Author: Tisha Norman
Co-Author(s): Petra Grami; Melissa Howell; Gregory Laine; Geraldine Jones; Jennifer Hoffman; Claudia Smith
Institution: St. Luke's Episcopal Hospital, Houston, TX
Contact Email: tisha_norman@att.net
Purpose: Sepsis wreaks havoc on the human body. Like a natural disaster, it moves fast and furiously, leaving devastation in its wake. The aftermath leaves us wrought with uncertainty, and expense. Sepsis survivors face increased mortality, length of stay, and costs. Sepsis drains the healthcare resources of our patients, hospitals, and nation. By providing Sepsis Guidelines education to hospital staff, we are promoting early recognition and treatment to avoid full-blown disaster.
Description: According to the 2008 Surviving Sepsis Campaign early recognition of sepsis and implementation of key strategies in the first six hours is paramount to averting disaster. Data from previous implementation of an ICU sepsis protocol illustrated statistically significant reductions in mortality, length of stay, ICU length of stay and ventilator days, demonstrating the need to initiate a house-wide program. This creative solution educates staff nurses in the acute care setting to recognize signs and symptoms of sepsis and implement a six-hour bundle. Early recognition enables them to initiate early treatment outside the ICU setting.
Development of an interprofessional Sepsis Task Force combined efforts to revise the existing sepsis protocol to facilitate early intervention in the acute care setting. The Task Force designed an educational offering that moved implementation of treatment across service lines, out of the ICU/ED and into the acute care setting. The taskforce utilized key stakeholders to promote collaboration and buy-in from MDs and RN staff outside the ICU. Educational opportunities are ongoing, with continuing education (CE) credits offered for RNs, and quarterly updates for MDs, pharmacy, and hospital leadership.
Evaluation/Outcomes: Initial implementation of an ICU “Sepsis Protocol” yielded a reduction of in-house sepsis-associated mortality rates from 40% to < 20%. To evaluate house-wide implementation efficacy, identical metrics will be utilized. Effectiveness of RN education will be measured through satisfaction surveys; MD education by use of the six-hour bundle outside the ICU. Ongoing hospital-wide education will insure sustainability of the sepsis initiative. Early recognition and treatment of sepsis must become ingrained into the hospital culture and evolve as the standard of care. This alone will insure that we will continue to see positive outcomes associated with early sepsis intervention.
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