Document Type

Dissertation

Degree

Doctor of Nursing Practice

Major

Nursing

Date of Defense

7-8-2020

Graduate Advisor

Susan Dean Baar

Co-Advisor

Louise Miller

Committee

Gerry Huber

Abstract

Problem: According to the Centers of Disease Control and Prevention (CDC, 2016), it is estimated that sepsis affects around 1.5 million individuals in the United States annually, causing the death of 250,000 individuals and being responsible for one out of three hospital deaths. One-fourth of patients who develop severe sepsis will die during their hospital stay. Delays in sepsis treatment contribute significantly to increased morbidity, mortality, and length of stay in the hospital. The Centers for Medicare and Medicaid (CMS) sepsis bundle guideline adherence rate in the Emergency Department of a Level III Trauma Center was stagnant at 55% through October 2019. A virtual sepsis consult was initiated in the Emergency Department of a Level III Trauma Center to potentially enhance the adherence rate.

Methods: This quality improvement project used a descriptive pre-post design, and the Plan-Do-Study-Act (PDSA) methodology to evaluate the sepsis bundle process.

Results: Sixty-one (N=61) sepsis cases were reviewed in this project. Twenty-three (N=23, 37%) were pre-project and 38 (N=38, 63%) were during the project. Results of the two-tailed independent sample z-test were not significant using an alpha value of 0.05, t (55) = -0.27, p=.791. A two-tailed independent sample t-test was conducted and showed there was not a significant difference between pre-project and project data on the number of false negative and false positive sepsis cases.

Implications for practice: Healthcare systems that utilize a virtual sepsis consult could standardize their workflow processes around sepsis care. Analysis of a larger number of cases may lead to significant results, which should be expected when workflow is improved.

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