急诊室护士主导的败血症代码,缩短使用抗生素的时间。

IF 0.8 Q4 NURSING
Leslie Gomez, Kelli LeClair, Danisha Jenkins, Mary Ann David, Jillian Downing, Julie Graham
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引用次数: 0

摘要

本文章由计算机程序翻译,如有差异,请以英文原文为准。
ED Nurse-Led Code Sepsis to Reduce Time to Antibiotics.

Background: Delays in sepsis recognition contribute to delays in antibiotic administration, which lead to increased morbidity and mortality in patients with sepsis. Our objective was to create an Emergency Department (ED) Code Sepsis Nurse-led team to reduce the time to antibiotics and mortality in patients with sepsis.

Methods: This initiative was implemented at a community hospital in Southern California in response to previous undesirable sepsis outcomes. In fiscal year 2021, the ED Sepsis Nursing Team was launched with the goal of improving sepsis-related outcomes. The following interventions were implemented: First, a group of dedicated Sepsis Nurses with training specific to sepsis recognition was created, and an electronic ED-sepsis screening tool was developed and implemented. Next, the dedicated sepsis nurses designed and educated to a "Code Sepsis" activation process. The code triggered a multidisciplinary response and implementation of standing orders for blood cultures, lactate, complete blood count, complete metabolic panel, and chest x-ray or urinalysis if indicated. Finally, the Sepsis Team Registered Nurse (RN) Captain led house-wide monthly Sepsis Task Force meetings to improve unit-level engagement and to allow the team to have ownership over sharing wins and losses.

Results: By Quarter 4 (Q4) of Fiscal Year 2021, door-to-antibiotic time for sepsis patients dropped from 196.7 min (Q1) to 144.7 (Q4). Additionally, mortality dropped below the health system average (10.4% vs. 13.5%), and Fiscal Year 2021 surpassed the readmissions benchmark of <1.0 at a rate of 0.5.

Conclusion: An RN-led, interprofessional response to accepted sepsis identification criteria enhanced staff and physician engagement and improved sepsis outcomes for patient mortality and hospital reporting outcomes. The process was adopted with very few obstacles that were easily overcome as the understanding of the role and its significance was realized.

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来源期刊
CiteScore
0.90
自引率
0.00%
发文量
97
期刊介绍: Advanced Emergency Nursing Journal is a peer-reviewed journal designed to meet the needs of advanced practice clinicians, clinical nurse specialists, nurse practitioners, healthcare professionals, and clinical and academic educators in emergency nursing. Articles contain evidence-based material that can be applied to daily practice. Continuing Education opportunities are available in each issue. Feature articles focus on in-depth, state of the science content relevant to advanced practice nurses and experienced clinicians in emergency care. Ongoing Departments Include: Cases of Note Radiology Rounds Research to Practice Applied Pharmacology
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