Date of Graduation

Spring 5-19-2017

Document Type

Project

Degree Name

Master of Science in Nursing (MSN)

College/School

School of Nursing and Health Professions

First Advisor

Elena Capella EdD, MSN, CNL

Second Advisor

Mary Seed PhD, MSN, BSN

Third Advisor

John Winchell Director of Nursing eICU (Preceptor)

Abstract

Sepsis costs over 20 billion dollars annually to treat making it the most expensive diagnosis for hospitals (Afrefian, et al., 2017) and carries with it an average mortality rate of 45% (SCCM, 2016). The eICU/ICU collaborative project was developed to improve sepsis mortality at Sutter Health’s Solano hospital affiliate from 41.2% to the system-wide goal of 18.8% over the course of a year by implementing two technologies. The first was the onboarding of the non-invasive cardiac output monitoring (NICOM) technology by Sutter Solano to fulfill the 6-hour bundle compliance for septic shock resuscitation. The other technology was the activation and enhancement of the Core Measure Manager (CMM) high-quality data surveillance technology by Sutter’s eICU to screen all patients at Sutter Solano Medical Center for early identification and treatment of sepsis and septic shock. After twelve months of quality improvement measures including education, training, implementation, enhancement, tracking and treatment management; the dashboards revealed Sutter Solano’s sepsis/septic shock mortality rate dropped from 41.2% to 6.1%. Nurses and physicians need to recognize that central venous pressure (CVP) is no longer a recommended or accepted measure of hemodynamic stability. The latest evidence-based practice supports NICOM in conjunction with passive leg raise (PLR) as a foundational guideline for fluid resuscitation. The Clinical Nurse Leader (CNL), as systems analyst and risk anticipator, must manage information as well as the care environment to improve quality patient outcomes in the presence of evolving knowledge and the ever-changing healthcare system (AACN, 2013).

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