Date of Graduation

Spring 5-18-2023

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)

College/School

School of Nursing and Health Professions

Program

MSN project

First Advisor

Scout Hebinck

Abstract

An emergency department (ED) has experienced inconsistency in achieving full compliance with elements of its early sepsis management protocol. The project aims to increase initiation of the RN ‘Suspected Sepsis in Triage Standardized Procedures’ order set, utilization of the smart-phrase handoff tool, and Severe Sepsis and Septic Shock Management Bundle (SEP-1) bundle compliance. In-person education was delivered to ED nurses during ten shift change meetings, and sepsis educational materials were designed and distributed throughout the unit and at each computer workstation. Educational materials were posted to the staff bulletin board, including ED-specific benchmarks and additional information on how to access the order set and handoff tool in the electronic health record (EHR).

The primary outcome measure was overall RN ‘Suspected Sepsis in Triage Standardized Procedure’ order set usage in patient cases where a positive sepsis screen is determined. Secondary measures included the sepsis handoff smart-phrase usage among ED RNs and overall SEP-1 bundle compliance rate for the hospital.

After implementation, the unit experienced an increase in nurse order set and handoff smart-phrase usage. The project revealed that nurses at the clinical site are highly skilled and knowledgeable about early sepsis recognition, treatment, and components of the bundles. Therefore, the intervention focused on reinforcing the sepsis standard work, offering clarification on the order set protocols, and encouraging usage of smart-phrase to promote efficiency and continuity of care. The implementation of targeted education represents a low-cost, high-return model that can be applied to other microsystems that seek to further refine sepsis management response. The project serves as a first step toward addressing inconsistencies and closing some gaps within this clinical site’s sepsis response, and demonstrates that small actions can make meaningful change.

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