Sepsis: Where’s the Fluid?

Ochsner Medical Center (Kenner, Louisiana)

CSI Summary

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CSI Presentation

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CSI Toolkit

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Project Topic

Sepsis outcome improvement and education

Hospital Unit

Intensive Care Unit (ICU)

CSI Participants

Courtney Boudreaux, BSN, RN
Diana Green, BSN, RN, CCRN
Lexie Green, BSN, RN, CCRN
Danielle Nelson, BSN, RN, CCRN
Natalie Santos, BSN, RN-BC, CCRN

Project Goals/Objectives

  1. To increase compliance of sepsis bundle components within 3 hours of time zero 30%
  2. To educate 90% of staff nurses on sepsis, sepsis protocol, and the sepsis bundle

Project Outcomes

  1. Decreased sepsis mortality rate 27.8% from 2018 to 2019
  2. Decreased average sepsis length of stay 3.36 days from 2018 to 2019
  3. These outcomes reduced the average cost of an ICU admission for sepsis by $17,909 and for septic shock by $22,163.

Project Overview

Improving sepsis outcomes is a system-wide initiative for Ochsner Health. At Ochsner Medical Center Kenner, we noticed a lack of staff education surrounding sepsis, a low degree of compliance in using our sepsis bundle order set and a significant number of patients not receiving adequate fluid resuscitation once diagnosed with sepsis.

Once we were able to get the data we needed, we discovered that the biggest opportunities to improve outcomes were on our medical surgical and telemetry floors, where rapid responses are typically called. Our CSI team provided additional education to the staff on these units. We created a video to make it fun and easy for staff to become educated and engaged in sepsis awareness, and encouraged them to act as sepsis advocates and feel empowered to speak up to physicians. We also provided education to the nurses, residents and physicians in our own unit.

Since the implementation of our project, we have seen increases in the number of rapid response calls (a good thing) and in the timeliness of fluid and antibiotic administration to septic patients. The overall sepsis mortality rate has decreased as well as the overall average ICU length of stay.

We hope to have our educational video and project outcomes presented throughout the system. Our team is also creating an educational poster and short presentation to include in our annual skills fair, which help with the sustainability of our project.

Permission to Reuse Materials
The materials associated with this AACN Clinical Scene Investigator (CSI) Academy project are the property of the participating hospital noted above, not AACN. Requests to use content contained in the CSI team’s summary, presentation or toolkit should be directed to the hospital. We suggest reaching out to the hospital’s Communications, Marketing or Nursing Education department for assistance.

Disclaimer
The AACN CSI Academy program supports change projects based on quality improvement methods. Although CSI teams seek to ensure linkage between their project and clinical/fiscal outcomes, data cannot be solely attributed to the project and are estimations of impact.