Lauren Gripp1, Melanie Raffoul2, Kerry A Milner3. 1. NYU Langone Health, 550 1st Ave, New York, NY 10016, United States; Davis & Henley College of Nursing, Sacred Heart University, 5151 Park Avenue, Fairfield, CT 06825, United States. Electronic address: Lauren.Gripp@nyulangone.org. 2. NYU Langone Health, 550 1st Ave, New York, NY 10016, United States. Electronic address: Melanie.Raffoul@nyulangone.org. 3. Davis & Henley College of Nursing, Sacred Heart University, 5151 Park Avenue, Fairfield, CT 06825, United States. Electronic address: milnerk@sacredheart.edu.
Abstract
OBJECTIVE: To improve timely sepsis care by implementing the 2018 Surviving Sepsis Campaign one-hour interventions. DESIGN: Ten-month prospective quality improvement project. SETTING: A 38-bed short stay unit within an 800-bed hospital in New York City. PARTICIPANTS: Patients admitted to the short stay unit who screened positive for sepsis. INTERVENTION: A sepsis implementation tool was created from the 2018 Surviving Sepsis Campaign guidelines. Sepsis champions delivered education on sepsis recognition, treatment, and management, and the sepsis implementation tool to the healthcare staff. PROCESS AND OUTCOME MEASURES: Time to first lactate, blood cultures × 2, antibiotic administration, length of stay and mortality were tracked weekly for five months. RESULTS: From May 6, 2019 to October 1, 2019, 32 patients were diagnosed with sepsis. Initial lactate and blood cultures were completed on every patient within 1one-hour of sepsis diagnosis. Administration of antibiotics within one-hour reached 100% after week four and was sustained. CONCLUSION: Use of a registered nurse-initiated sepsis implementation tool in a short stay unit led to the completion of blood cultures, initial lactate, and antibiotic administration within one-hour. Key factors to support this practice improvement were increasing registered nurse, physician and physician assistant sepsis knowledge, registered nurse and physician/physician assistant early collaboration, increased staffing and intravenous access equipment.
OBJECTIVE: To improve timely sepsis care by implementing the 2018 Surviving Sepsis Campaign one-hour interventions. DESIGN: Ten-month prospective quality improvement project. SETTING: A 38-bed short stay unit within an 800-bed hospital in New York City. PARTICIPANTS: Patients admitted to the short stay unit who screened positive for sepsis. INTERVENTION: A sepsis implementation tool was created from the 2018 Surviving Sepsis Campaign guidelines. Sepsis champions delivered education on sepsis recognition, treatment, and management, and the sepsis implementation tool to the healthcare staff. PROCESS AND OUTCOME MEASURES: Time to first lactate, blood cultures × 2, antibiotic administration, length of stay and mortality were tracked weekly for five months. RESULTS: From May 6, 2019 to October 1, 2019, 32 patients were diagnosed with sepsis. Initial lactate and blood cultures were completed on every patient within 1one-hour of sepsis diagnosis. Administration of antibiotics within one-hour reached 100% after week four and was sustained. CONCLUSION: Use of a registered nurse-initiated sepsis implementation tool in a short stay unit led to the completion of blood cultures, initial lactate, and antibiotic administration within one-hour. Key factors to support this practice improvement were increasing registered nurse, physician and physician assistant sepsis knowledge, registered nurse and physician/physician assistant early collaboration, increased staffing and intravenous access equipment.
Authors: Jeannie P Cimiotti; Edmund R Becker; Yin Li; Douglas M Sloane; Scott K Fridkin; Anna Beth West; Linda H Aiken Journal: JAMA Health Forum Date: 2022-05-27
Authors: Francisco Martín-Rodríguez; Laura Melero-Guijarro; Guillermo J Ortega; Ancor Sanz-García; Teresa de la Torre de Dios; Jesús Álvarez Manzanares; José L Martín-Conty; Miguel A Castro Villamor; Juan F Delgado Benito; Raúl López-Izquierdo Journal: Dis Markers Date: 2022-02-23 Impact factor: 3.434