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Improving the care of patients with sepsis through an interprofessional approach
An interprofessional approach to sepsis care improves early identification and application of evidence based care for patients with sepsis. Early treatment leads to a significant decrease in patient mortality from sepsis.
Significance:
Sepsis is a clinical syndrome with mortality rates range from 25 – 50%. Patient presentation is often vague resulting in missed opportunity for treatments. The Surviving Sepsis Campaign (SSC) identified that outcomes improve significantly when sepsis is quickly diagnosed and treated (2012).
Strategy and Implementation:
Four urban academic hospitals formed an interprofessional task force in an attempt to improve identification and application of the SSC Guidelines. This study was conducted as a pre and post intervention, one group study and investigate the effects of an interprofessional educational interventions on evidence based sepsis care. A retrospective analysis was conducted at three phases between September 2010 and February 2012. Phase One data reflected sepsis care components before an electronic alert was initiated. Phase Two data reflected sepsis care components immediately after the electronic alert was instituted. Phase Three represented sepsis care eight weeks after education was provided to the interprofessional staff. Sepsis care was measured in relation to lactate completion, blood cultures obtained before antibiotic administration, and timeliness of antibiotic administration in comparison to order entry.
Evaluation:
There was a statistically significant difference between phases for lactate completion X2=16.908(p<0.001);blood cultures before antibiotics nearing statistical significance(p<0.054);and improvement in antibiotic administration between Phase 2 to 3 with mean time in minutes of 182 vs 92 minutes.
Implications for Practice:
The implications for practice include elevating the sense of urgency to identifying and treating patients in a timely and appropriate manner through education. Ongoing evaluation of methods to facilitate compliance for early identification and bundle components is needed.