Date of Graduation

12-12-2023

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

Abstract

Abstract

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 and hospital length of stays.

Context: A group of students studying to become Clinical Nurse Leaders (CNLs) evaluated Hospital A's Emergency Department (a clinical microsystem) located in the greater Bay Area. This microsystem provides diverse emergency care for patients with various medical conditions and diagnoses. The CNL students concentrated on patients diagnosed with sepsis for their quality improvement project.

Interventions: Although time constraints prevented the implementation of interventions, the CNL students proposed recommendations to the leadership team for follow-up. Recommendations for interventions centered on improving interprofessional education and training regarding overall sepsis management. In addition to establishing a comprehensive sepsis protocol to standardize sepsis management in the Emergency Department.

Measures: After assessing the microsystem, CNL students collected data to evaluate the nurses' knowledge of the sepsis bundle and Hospital A’s sepsis policy. The data also served to identify any barriers nurses experienced while implementing the bundle, along with any complications that arose during treatment. A post-intervention survey could not be performed due to tim constraints.

Results: In the survey questionnaire, 41 nurses participated, resulting in a 36% response rate. Key findings showed that 31% of the nurses would like to see a revision to the sepsis policy. Additionally, 61% of the nurses reported receiving no debriefing counsel when compliance measures were unmet. Also, 70% of the nurse's escalation processes did not follow the chain of command. 26.8% of identified barriers were difficulties establishing intravenous access. 33.8% of nurses cited poor staffing, training, and nursing experience as additional barriers. Meanwhile, 80% of the nurses acknowledged the sepsis treatment timeline.

Conclusions: The results of the pre-intervention survey questionnaire suggest that standardization is missing in sepsis management. The hope is that with the ongoing progress of this project, which includes increasing educational measures and accessible resources, the sepsis bundle will be deployed and utilized efficiently. Ultimately, this will help to improve sepsis mortality and morbidity occurrences.

Keywords: Emergency Department, sepsis bundle, ultrasound, early sepsis management, sepsis education, and standardizing care.

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