Document Type

Dissertation

Degree

Doctor of Nursing Practice

Major

Nursing

Date of Defense

7-9-2021

Graduate Advisor

Laura Kuensting, DNP, APRN, PCNS-BC, CPNP, CPEN

Committee

Laura Kuensting, DNP, APRN, PCNS-BC, CPNP, CPEN

Roxanne Reid, DNP, RN

Jessica Peterson, MSN, RN

Abstract

Problem: Sepsis is the leading cause of morbidity and mortality and antibiotic administration within 60-minutes is a priority. The purpose of this quality improvement project was to improve sepsis patient’s outcomes by administering parenteral antibiotics within 60-minutes of a code sepsis (CS) activation.

Method: Observational descriptive design utilizing a retrospective medical record review over a three-month period in 2020 and 2021. A purposive sampling of adult patients from a Midwestern, metropolitan, Level II trauma and medical center emergency department (ED) were selected.

Results: The administration of parental antibiotics once a sepsis bundle was activated was essentially 28-minutes in 2020 and 2021 (t (416)=0.16, p=.874). This is well within the recommended 60-minutes by Surviving Sepsis Campaign (SSC). In addition, there was a weak relationship found between antibiotic administration time and LOS for 2020 (r=-0.01; CI [-0.13, 0.11]; p=.910), and also for 2021 (r=0.02; CI [-0.11, 0.16]; p=.745). Results of a Fisher exact test found home or self-care was significant (in 2020: 128 [100.81]; in 2021: 53 [80.19], p

Implications: Antibiotic administration times were less than 60-minutes in 2020 and 2021. The LOS and final disposition were essentially unchanged. The Covid-19 pandemic may influence these results. Regardless, sepsis remains a leading cause of death in adults and continuous quality improvement may drive better outcomes.

Keywords: sepsis, sepsis bundle, and door-to-antibiotic time for sepsis treatment

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