Problem: Sepsis, a life-threatening condition, can rapidly progress to death. The Hospital Inpatient Quality Reporting program has implemented bundled care metrics for sepsis care, but timely completion of these interventions is challenging. Best-practice interventions could improve patient outcomes and reimbursement. The purpose of this project was to improve the timeliness of sepsis recognition and implementation of bundled care interventions in the emergency department.
Methods: This evidence-based practice improvement project implemented a Detect, Act, Reassess, Titrate (DART)-based nursing protocol embedded within a checklist communication tool in the emergency department of a tertiary level-2 trauma center. Data comparisons between preintervention and post-DART protocol/checklist implementation included compliance with the individual Inpatient Quality Reporting 3-hour bundled elements, number of hospital days, and time to screen. Staff also completed a survey designed to assess their satisfaction with the DART algorithm/checklist. The Pearson χ test was used to assess bundled-care intervention variables. Wilcoxon rank sum tests were used to explore hospitalization outcomes. Staff satisfaction survey results were summarized.
Results: Improvement was statistically significant for lactate levels, blood cultures, and early antibiotic administration in the intervention period compared with baseline. Time to screen, ED length of stay, and number of hospital days improved between baseline and the intervention period, with an average number of hospital days decreasing by 2.5 days. Compliance with all Inpatient Quality Reporting metrics increased from 30% to 80%.
Discussion: When the nurse-driven protocol and communication tool were implemented, compliance with time-sensitive sepsis bundled interventions improved significantly. The outcomes suggest nurse-driven protocols can improve sepsis outcomes.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jen.2019.05.005 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Severe maternal morbidity contributed by obstetric hemorrhage: Maryland, 2020-2022.
Am J Obstet Gynecol MFM
January 2025
Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St Suite E8527, Baltimore, MD 21205; Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St Suite E8527, Baltimore, MD 21205; Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, 550 North Broadway Baltimore, MD 21205.
Background: Obstetric hemorrhage is the leading cause of maternal mortality and severe maternal morbidity (SMM) in Maryland and nationally. Currently, through a quality collaborative, the state is implementing the Alliance for Innovation on Maternal Health (AIM) patient safety bundle on obstetric hemorrhage.
Objective: To describe SMM events contributed by obstetric hemorrhage and their preventability in Maryland.
IMPACT-ICU feasibility study: pragmatic mixed-methods randomised controlled trial of a follow-up care intervention for survivors of critical illness and caregivers.
BMJ Open
January 2025
Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada.
Introduction: Survivors of critical illness and their caregivers are at risk for long-term cognitive, physical and psychiatric impairments known as post-intensive care syndrome (PICS) and PICS-family, respectively. This study will assess the feasibility of a randomised controlled trial (RCT) evaluating an intensive care unit (ICU) follow-up care bundle versus standard-of-care for ICU patients and their caregivers.
Methods And Analysis: This is a single-centre feasibility study.
Sustainable reduction in sound levels on intensive care units through noise management - an implementation study.
BMC Health Serv Res
January 2025
Center of Implementing Nursing Care Innovations Freiburg, Nursing Direction, Medical Center - University of Freiburg, Freiburg, Germany.
Background: The noise levels in intensive care units usually exceed the recommended limits in (inter)national recommendations. Such noise levels can affect both the recovery of intensive care patients and the performance of staff. The aim of this study was to reduce ward-based noise levels in three intensive care units (anesthesiological, neurological, and neonatological).
View Article and Find Full Text PDFPerioperative emergency laparotomy pathway for patients undergoing emergency laparotomy: A propensity score matched study.
Ann Acad Med Singap
December 2024
Department of Surgery, Ng Teng Fong General Hospital, Singapore.
Article Synopsis
- Emergency laparotomy (EL) has high morbidity and mortality rates, prompting a study on
A Nurse-Initiated Protocol for Interprofessional Management of Changed Behaviours in Hospital Patients With Dementia and/or Delirium: A Modified e-Delphi Study.
J Adv Nurs
January 2025
Nursing Practice Development Unit, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.
Aim: To develop a nurse-initiated protocol for early ward-based interprofessional coordination and formulation of person-centred care plans to assist in point-of-care management of behaviour in older patients on general hospital wards.
Design: A modified e-Delphi method was employed to establish expert consensus.
Method: Multidisciplinary acute-care experts experienced in hospital care of patients with dementia and/or delirium in Australia were recruited by email from 35 professional networks.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!