The Use of an Educational Tool to Improve Adjustment to the Sepsis Protocol and the Clinical Impact (original) (raw)
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Initial, successful implementation of sepsis guidelines in an emergency department
Danish medical journal, 2012
Early screening and treatment of sepsis can reduce mortality. Region Zealand established guidelines for the diagnosis and treatment of sepsis. We assess an interdisciplinary intervention for implementation of these guidelines at the Department of Emergency Medicine at Nykøbing Falster Hospital from July 2009 to August 2010. Structured training was imparted to personnel during the first 18 weeks. Electronically accessible guidelines, posters with diagnostic and treatment algorithms, pocket references and checklists were made available to encourage adherence to the guidelines. Key nurses and doctors encouraged compliance. Journal audits (at baseline, 18 weeks and one year) were undertaken to measure adherence to six elements of the sepsis guidelines: lactate measurement, oxygen and fluid treatment, timely antibiotic treatment, blood culture and planning of treatment monitoring. A total of 27 (baseline), 29 (18 weeks) and 48 (one year) patients were included for analysis. Adherence to ...
An Evidence Based Approach to Sepsis: Educational Program
2015
Evidence-based guidelines for recognizing and treating sepsis have been available for decades, yet healthcare providers do not adhere to the recommendations. Sepsis can progress rapidly if not recognized early. Literature reports reveal that sepsis is the leading cause of death in non-cardiac intensive care units (ICUs), and it is one of the most expensive conditions to treat. A hospital in the Las Vegas, Nevada area had previously introduced sepsis management prescriptions in 2011 with no formal education of sepsis guidelines to nurses. The original hospital's sepsis management prescription sets followed guidelines dated 2008. The purpose of this project was to revise sepsis management prescriptions, develop a sepsis protocol, and develop and present a sepsis education presentation for nurses. The subject population for the educational presentation included registered nurses from critical care departments, medical-surgical departments, women's departments, and the emergency...
Nursing: Research and Reviews
Background: Sepsis is a global pandemic and public health concern. There is a paucity of data relating to its management and outcomes in the developing world. The surviving sepsis campaign (SSC) guidelines have been developed to improve outcomes of patients with sepsis. There are no documented in-hospital protocols on sepsis management for nurses in Uganda. This study evaluated the effect of an educational intervention on nurses' knowledge of SSC guidelines in management of patients with sepsis at Mulago National Referral Hospital. Methods: We used a quasi-experimental design and recruited 40 nurses from neuro-surgical ward and ICU. Pre-and post-intervention assessments were conducted using a validated self-administered questionnaire between October 2020 to February 2021. The intervention was conducted through sessions of presentations, watching videos, and case studies. Data were entered in excel, cleaned, and exported to Stata version 16. Median and interquartile range were used for continuous variables while frequencies and percentages were used for categorical variables. Mean knowledge scores were computed for pre-and post-test evaluation. A paired t-test was used to compare the pre-and post-test knowledge scores at p ≤ 0.05 and 95% confidence interval. Results: In this study, 57.5% of nurses were from ICU, 67.7% were females and 70% diploma holders. Median age was 32 (IQR= 21.5-35.5) years. In the post test all nurses were able to score above the preset acceptable score of 50% on the current sepsis guidelines. Mean knowledge score was 3.6 (SD = 1.8) pretest and 8.4 (SD = 1.2) posttest. There was a significant difference in pre and post-intervention mean knowledge scores of 4.9 (SD = 1.90, 95% CI: 4.2-4.5; t (39) = 16.242, p <0.001). Conclusion: The educational intervention improved nurses' knowledge on SSC guidelines. Regular continuous professional nursing education on sepsis could improve nurses' knowledge and quality of care for patients with sepsis.
Sepsis Awareness at the University Hospital Level: A Survey-Based Cross-Sectional Study
2021
Background: Sepsis is a leading cause of morbidity and mortality. Prompt recognition and management are critical to improved outcomes. In 2019, the Lausanne University Hospital (LUH) launched a quality of care project aiming to improve sepsis management. As part of this effort, we aimed to assess sepsis awareness among nurses and physicians of the LUH and among the local paramedics. Methods: We conducted a survey on nurses and physicians at our institution and local paramedics between January and October 2020 representing over 1,000 professionals distributed over all hospital departments. The survey assessed professionals’ knowledge of sepsis epidemiology, definition, recognition and initial evaluation (nurses and paramedics) or sepsis epidemiology, diagnosis, and management (physicians). Pediatrics and the neonatal unit were excluded. Results: A total of 1,116 of 1,216 contacted persons among the 4417 targeted population participated and completed the survey (participation rate 91....
Improving Care of the Sepsis Patient
The Joint Commission Journal on Quality and Patient Safety, 2008
Background: In 2004, Christiana Care Health System (Christiana Care), a 1,100-bed tertiary care facility, used the Surviving Sepsis Campaign guidelines as the foundation for an independent initiative to reduce the mortality rate by at least 25%. Methods: In 2004, an interdisciplinary sepsis team developed a process for rapidly recognizing at-risk patients; evaluating a patient's clinical status; and providing appropriate, timely therapy in three major areas of sepsis care; recognition of the sepsis patient, resuscitation priorities, and intensive care management. The Sepsis Alert program, which did not require additional staffing, was developed and implemented in 10 months. The Sepsis Alert packet included a care management guideline, a treatment algorithm, an emergency department treatment order set, and multiple adjuncts to streamline patient identification and management. Results: Introduction of sepsis resuscitation and critical care management standards led to a 49.4% decrease in mortality rates (p < .0001), a 34.0% decrease in average length of hospital stay (p < .0002), and a 188.2% increase in the proportion of patients discharged to home (p < .0001) when the historic control group is compared with the postimplementation group from January 2005 through December 2007. Discussion: An integrated leadership team, using existing resources, transformed frontline clinical practice by providers from multiple disciplines to reduce mortality in the population of patients with sepsis.
Critical care (London, England), 2018
Early appropriate antibiotic treatment is essential in sepsis. We aimed to evaluate the impact of a multifaceted educational intervention to improve antibiotic treatment. We hypothesized that the intervention would hasten and improve the appropriateness of empirical antibiotic administration, favor de-escalation, and decrease mortality. We prospectively studied all consecutive patients with sepsis/septic shock admitted to 72 intensive care units (ICUs) throughout Spain in two 4-month periods (before and immediately after the 3-month intervention). We compared process-of-care variables (resuscitation bundle and time-to-initiation, appropriateness, and de-escalation of empirical antibiotic treatment) and outcome variables between the two cohorts. The primary outcome was hospital mortality. We analyzed the intervention's long-term impact in a subset of 50 ICUs. We included 2628 patients (age 64.1 ± 15.2 years; men 64.0%; Acute Physiology and Chronic Health Evaluation (APACHE) II, 2...
BMC Anesthesiology, 2012
Background: Signs of serious clinical events overlap with those of sepsis. We hypothesised that any education on severe sepsis/septic shock may affect the outcome of all hospital patients. We designed this study to assess the trend of the mortality rate of adults admitted to hospital for at least one night in relationship with a hospital staff educational program dedicated to severe sepsis/septic shock. Methods: This study was performed in six Italian hospitals in the same region. Multidisciplinary Sepsis Teams members were selected by each hospital management among senior staff. The education included the following steps: i) the Teams were taught about adult learning, problem based learning, and Surviving Sepsis guidelines, and provided with educational material (literature, electronic presentations, scenarios of clinical cases for training and booklets); ii) they started delivering courses and seminars each to their own hospital staff in the last quarter of 2007. To analyse mortality, we selected adult patients, admitted for at least one night to the wards or units present in all the study hospitals and responsible for 80% of hospital deaths. We fitted a Poisson model with monthly hospital mortality rates from December 2003 to August 2009 as dependent variable. The effect of the educational program on hospital mortality was measured as two dummy variables identifying a first (November 2007 to December 2008) and a second (January to August 2009) education period. The analysis was adjusted for a linear time trend, seasonality and monthly average values of age, Charlson score, length of stay in hospital and urgent/non-urgent admission.
2023
Previous research has explored nurses´ experience with the implementation of early detection alert systems, and nurses and physicians' perceptions of sepsis management and use of sepsis triage. As one of the first, this study aims to investigate the perceived usefulness of an interdisciplinary quality improvement project including standardized sepsis patient pathway to improve the early identification and treatment of sepsis patients. Participants and Methods: This study was a qualitative study that employed semi-structured interviews with thirteen ward nurses and five ward physicians recruited by convenience and respondent-driven sampling, respectively. The interviews explored the perceived usefulness of mutual training in sepsis care in medical hospital wards. We applied Systematic Text Condensation to analyze the experiences and knowledge of professional identification and cooperation in early identification of sepsis patients. Results: The results revealed three main themes: Awareness of sepsis, collaboration between nurses and physicians, and clinical assessment and judgement. The findings highlighted the positive impact of the project in terms of raising awareness, improving communication, and enhancing the ability to detect and treat sepsis. The study also identified the importance of repetition and reminders to maintain awareness, the need for ongoing training for new healthcare professionals, and the challenges of collaboration and decision-making processes. Conclusion: The sepsis intervention seemed successful in improving awareness of sepsis and enhancing interprofessional collaboration between nurses and physicians. Health professionals continued to rely on their clinical judgment but increased the use of objective measurements and communication of vital signs. Continuous repetition and education for new colleagues were identified as important factors for the sustainability of the intervention. Overall, the study highlights the importance of standardized protocols and training for early detection and management of sepsis in healthcare settings.