Date of Graduation

Fall 12-15-2023

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)


School of Nursing and Health Professions


MSN project

First Advisor

Dr. Nneka Chukwu, MBA, RN, CLNC, CNL


Problem: This quality improvement project aims to enhance early sepsis management and sepsis bundle compliance among Emergency Department nurses to reduce the risk of sepsis-related deaths as well as hospital length of stays.

Context: A microsystem assessment, in the emergency department (ED) unit, was performed in Hospital A located in the Greater San Francisco Bay area by Clinical Nurse Leader (CNL) students. This ED unit cares for a variety of critical care patients ranging from urgent to life-threatening conditions.

Intervention: An intervention was not implemented in the ED unit due to time constraints and limitations; however, CNL students provided recommendations so stakeholders could further investigate and implement them. The recommended interventions include increasing sepsis bundle training frequency, refining intravenous placement skills through training and readily available resources, establishing a standardized sepsis protocol, providing nurses badge buddies, and revising the current charting system.

Measures: CNL students collected data to evaluate current sepsis care management and the rates of sepsis-related complications at the ED. The pre-intervention survey highlighted areas of improvement where proposed recommendations could help nurses utilize and adhere to sepsis bundle care more effectively.

Results: The most relevant pre-intervention questionnaire results revealed that 42% of ED nursing staff recommend protocol revision, 24.4% claim to not have attended any sepsis training with another 4.9% reporting rarely attending, and 46.3% reported there is no debriefing, or follow-up training, when sepsis bundle compliance is failed to be met. In addition, nurses identified barriers to meeting compliance such as difficult IV access or “hard sticks”, standing orders, and knowledge gaps.

Conclusions: A pre-intervention questionnaire given to ED nurses at Hospital A reveals gaps in knowledge and barriers to current sepsis management. Implementing a standardized sepsis protocol and offering nurses’ frequent sepsis bundles and intravenous training is recommended. The implementation of these recommended resources will hopefully improve nurses’ sepsis care management, improving patient outcomes and care quality.

Keywords: Sepsis, Emergency Department, Sepsis Bundle Compliance, Sepsis Management, Quality Improvement Project, Microsystem, Sepsis Training