Date of Graduation

Winter 12-16-2016

Document Type

Project

Degree Name

Doctor of Nursing Practice (DNP)

College/School

School of Nursing and Health Professions

Department/Program

Nursing

First Advisor

Juli Maxworthy DNP, MSN, RN, CNL, CPHQ, CPPS, CHSE

Second Advisor

Elena A. Capella EdD, MSN/MPA, RN, CNL, CPHQ, LNCC

Abstract

Healthcare organizations must be able to provide quality patient care from arrival to disposition that is both expedient and safe. The Agency for Healthcare Research and Quality ranks septicemia as the number one most expensive condition treated in U.S. hospitals, resulting in aggregate costs of $20.3 billion or 5.2% of the total aggregate cost for all hospitalizations. Starting October 2015, the Centers for Medicare & Medicaid Services began tying financial reimbursement to improvement of sepsis outcomes. For success to be achieved, organizations should partner with prehospital providers to improve sepsis care, similar to partnerships which have historically improved acute myocardial infarction and stroke care within communities. Activation of the 911 system, coupled with rapid prehospital assessment and priority transport, including pre-notification to the receiving emergency department, creates opportunities for accurate and timely diagnosis, along with implementation of lifesaving treatment immediately upon arrival or even in route. This project sought to improve recognition and treatment of sepsis through partnerships with our prehospital providers. Through education and collaboration, we saw improvement in recognition of the septic patient in the prehospital environment, leading to improved outcomes. These outcomes demonstrated reductions in mortality from severe sepsis and septic shock and a 1.5-day per patient reduction in overall hospital length of stay for DRGs 870, 871, and 872, resulting in an estimated cost savings of $3.1 million for the organization. Partnering with the community to educate and improve awareness and early recognition demonstrates potential in improving survival and reducing costs.

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