Implementation of the 1-Hour Sepsis Bundle and Evaluation of Staff Adherence: An Evidence-based Practice Quality Improvement Project

Objective: To implement an evidence-based sepsis implementation tool for nurses to use when initiating treatment for patients diagnosed with sepsis and to track time of administration of the Surviving Sepsis Campaign (SSC) 1-hour bundle interventions, mortality, and length of stay. Design: An evidence-based practice quality improvement (EBP-QI) project. Setting: A 38-bed observation/short stay unit within a 700-bed hospital in New York City. Intervention: A sepsis implementation tool was created based on SSC 2018 1-hour guidelines. Sepsis champions delivered education on sepsis recognition, treatment, and management to the nurses, physicians, and other staff. Main outcome measure: Following the practice change, audits of the sepsis implementation tool were done weekly for 5 months. A target of 85% completion for each of the bundle interventions was set. Results: From May 8, 2019 to October 8, 2019 a total of 38 patients were diagnosed with sepsis in the emergency department or observation/short stay unit and of these 90% (n=33) had blood cultures drawn twice, 85% (n=34) had stat lactate, and 73% (n=26) had broad-spectrum antibiotics started within 1-hour. The target of 85% was met for 2 of the 3 bundle interventions. Conclusion: The sepsis 1-hour bundle is best practice