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Description
QUALITY
Sepsis background:
Sepsis is the leading cause of death in children2 and a global health problem3. The primary source of infection is often not apparent1, making early patient identification, initiation of sepsis protocols, and continued awareness crucial to improve outcomes and prevent mortality in patients at risk for sepsis.
Purpose:
An emergency department (ED) Sepsis Response Team (SRT) and other initiatives were designed to enhance workflow efficiency, improve time to antibiotic administration (TTA) tominutes, improve sepsis recognition, and uphold standards by maintaining staff engagement.
Implementations:
Once a patient screens positive for sepsis risk, an SRT is immediately activated. A multidisciplinary team responds and promptly initiates treatment in accordance with sepsis protocols. In contrast, patients identified as high-risk upon arrival were directly taken to a room where the interdisciplinary team met them. Treatments were administered according to standing delegation orders and an algorithm for accessing ports/PIVs. Ongoing education, coaching, and skills development were prioritized to enhance sepsis recognition. An Escape Room simulation was also created to promote staff engagement and reinforce the importance of following sepsis protocols.
Results:
Over twenty-seven months, data tracked improvements in TTA. The percentage of patients utilizing a SRT increased from 42% to 58% in April-December 2022, rose to 76% in 2023, and reached 81% in June 2024. The high-risk population TTA increased from 59% to 85% in April-December 2022, reached 97% in December 2023, and remained 97% in May 2024. Sepsis recognition improved from 75% in 2023 to 88% in 2024 through the proper utilization of the screening tool. Staff engagement was evident in the Escape Room participation, with 100% of the participants successfully escaping within 12-14 minutes.
Conclusion:
Implementing new processes, education, and engagement initiatives through a collaborative approach has dramatically improved TTA and transformed the sepsis culture in the ED. The data shows that a multi-faceted approach involving the nursing staff and valuing everyone's contribution is crucial for improving sepsis care quality.
References
Hilarius, K. W., Skippen, P. W., & Kissoon, N. (2020). Early recognition and emergency treatment of sepsis and septic shock in children. Pediatric Emergency Care, 36(2), 101–106. https://doi.org/10.1097/pec.0000000000002043
Lane, R. D., Richardson, T., Scott, H. F., Paul, R. M., Balamuth, F., Eisenberg, M. A., Riggs, R., Huskins, W., Horvat, C. M., Keeney, G. E., Hueschen, L. A., Lockwood, J. M., Gunnala, V., McKee, B. P., Patankar, N., Pinto, V., Sebring, A. M., Sharron, M. P., Treseler, J.,...Workman, J. K. (2024). Delays to antibiotics in the emergency department and risk of mortality in children with sepsis. JAMA Network Open, 7(6), e2413955. https://doi.org/10.1001/jamanetworkopen.2024.13955
Martínez, M., Plata-Menchaca, E. P., Ruiz-Rodríguez, J., & Ferrer, R. (2020). An approach to antibiotic treatment in patients with sepsis. Journal of Thoracic Disease, 12(3), 1007–1021. https://doi.org/10.21037/jtd.2020.01.47
Publication Date
9-27-2024
Keywords
Sepsis, ED, Emergency Department
Disciplines
Pediatric Nursing
Recommended Citation
Elizondo, Virginia; Bizzack, Nicole; Dayton, Amber; Rodick, Angie; Collins, Ashley; Hernandez, Georgina; and Albiar, Amber, "Improving Sepsis Response, Awareness, and Engagement in the Emergency Department" (2024). 2024. 10.
https://scholarlycollection.childrens.com/nursing-anf2024/10
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
