Date on Paper

11-2024

Document Type

Doctoral Paper

Degree Name

D.N.P.

Department

Nursing

Committee Chair

Roser, Lynn

Committee Member

Harrington, Candace

Author's Keywords

Septic Shock; Sepsis; Sepsis Screen; Sepsis Bundles; SEP-1

Abstract

Background: Sepsis is attributable to more than one in three in-hospital deaths in the United States and 20% of deaths globally each year. In 2015, the Centers for Medicare and Medicaid Services (CMS) adopted an early goal-directed 3 and 6-hour bundle intervention measure titled “SEP-1” based on recommendations from the International Surviving Sepsis Campaign (SSC) consensus panel to improve patient outcomes in cases of severe sepsis and septic shock. Sepsis is most often identified in the emergency department (ED) setting due to 87% of cases beginning in the community (Sepsis Alliance, 2022). National compliance with SEP-1 is 50% despite a positive correlation between measure performance and patient outcomes, including costs, lengths of stay (LOS), morbidity, and mortality. A quality improvement (QI) project was designed to address SEP-1 knowledge gaps among emergency department providers and nurses.

Purpose: The purpose of this QI project was to increase ED nurse and provider knowledge of sepsis 3- and 6-hour early management and increase compliance of the facility’s sepsis bundle policy and SEP-1.

Methodology: The evidence-based project consisted of four phases: 1) a pre-assessment; 2) implementation of a sepsis education module highlighting facility-specific processes and past performance; 3) a post-assessment following the training; and 4) a 30-day post-assessment.

Results: Compliance with the ED sepsis policy decreased by 0.76% from the month preceding the sepsis education module to the first month after the training and by 46.67% from pre-intervention to the second post-intervention month while SEP-1 compliance improved from 80% to 100% and 88.89% respectively.

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