Date of Graduation

Spring 5-18-2023

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)


School of Nursing and Health Professions


MSN project

First Advisor

Nneka Chukwu

Second Advisor

Jennifer Zesati


Problem: Sepsis is a life-threatening complication of infection that can lead to tissue damage, organ dysfunction, and death. Early recognition and intervention are crucial in the management of sepsis. Delays in sepsis care can lead to adverse health outcomes and even death. Sepsis bundles are guided by evidence-based practice. They serve as guidelines for effective and timely management of sepsis. Adherence to these sepsis bundles is associated with overall improved morbidity and mortality.

Context: This quality improvement project was led by Clinical Nurse Leader (CNL) students from the University of San Francisco. It was implemented at a 244-bed not-for-profit hospital located in the San Francisco Bay Area, focusing on the medical-surgical/telemetry unit. The patient population within this microsystem consists of adults over the age of 18, commonly diagnosed with conditions such as sepsis, congestive heart failure, electrolyte imbalance, and alcohol withdrawal.

Intervention: The primary intervention involves administering a questionnaire on sepsis education and identifying gaps in sepsis intervention implementation. This initiative aims to enhance comprehension of the effectiveness of sepsis education among nurses, serving as the foundation for recommended future changes that are anticipated to increase nurse sepsis-bundle compliance.

Measures: Measures encompassed sepsis education/bundle training and its effectiveness, accessibility of the electronic Cardiac Arrest Risk Triage (eCART), barriers to sepsis-bundle compliance, the effectiveness of the rapid response process, and recommendations for enhancing sepsis-bundle compliance.

Results: With 36 responses, the questionnaire had a 67% response rate. Key findings included: 17% of nurses have not received sepsis training, 50% of nurses that did receive training found that the training method was effective, 89% of nurses felt that rapid response is effective when managing the care of sepsis patients, all nurses found the eCART to be easily accessible, and many nurses reported a need for refresher training courses as well as visual aids of the sepsis protocol available on the floor.

Conclusions: Increased sepsis-bundle compliance is a priority for this microsystem given the various gaps in sepsis care discovered. Bundle adherence can significantly decrease in-hospital mortality. The questionnaires administered to the nursing staff revealed a need for annual sepsis training, visual aids, and a simplified sepsis protocol. Data analysis and research in evidence-based practices provided the foundation for recommendations on how this microsystem can improve sepsis-bundle compliance and patient outcomes.