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Nursing
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Apr 28, 2024
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6
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PROMOTING QUALITY CARE IN SEPSIS IDENTIFICATION
1
Project Trigger and the Iowa Model Flowchart to Promote Quality Care in Sepsis
Identification
PROMOTING QUALITY CARE IN SEPSIS IDENTIFICATION
2
Project Trigger and the Iowa Model Flowchart to Promote Quality Care in Sepsis
Identification
In recent years, the management and prevention of sepsis have emerged as critical
priorities in healthcare settings worldwide. Sepsis, a life-threatening condition resulting from the
body's overwhelming response to infection, presents a significant challenge in emergency
departments due to its rapid progression and high mortality rates (Centers for Disease Control
and Prevention, 2018). This quality improvement project addresses the pressing need for
effective sepsis prevention, identification, and treatment strategies within the emergency
department. By identifying triggers for intervention, engaging key stakeholders, and
implementing evidence-based practices guided by the Iowa Model Flowchart, this project seeks
to promote timely recognition, early intervention, and optimal management of sepsis cases.
Triggers for Project
The trigger for this project is the suboptimal identification and treatment of sepsis cases
in our emergency department.
Description of Problem
Our facility has identified a concerning gap in the timely recognition and management of
sepsis cases within the emergency department. Data from the past year reveals instances where
sepsis cases were either missed or not treated promptly, leading to adverse patient outcomes and
increased mortality rates. In fact - over half of all septic patients (an estimated 800 patients of
1000 identified and audited throughout 2023) were completely missed by triage nurses, doctors,
and primary nurses upon emergency room arrival. Because of this, there were missed
opportunities of delayed antibiotic administration and fluid resuscitation, contributing to
PROMOTING QUALITY CARE IN SEPSIS IDENTIFICATION
3
prolonged hospital stays and higher healthcare costs. These findings highlight the critical need to
improve sepsis identification and treatment protocols in our emergency department.
Priority for Organization and Team Members
The primary stakeholders for this quality improvement project include emergency
department staff, hospital administration, infectious disease specialists, and the quality
improvement team. Engaging these stakeholders is crucial for the successful implementation and
sustainability of sepsis identification and treatment protocols. Strategies for engagement include
regular meetings with emergency department staff to discuss protocol implementation,
presentations to hospital administration highlighting the importance of resource allocation,
collaboration with infectious disease specialists for protocol development, and involvement of
the quality improvement team in monitoring and evaluation.
Evidence to Conduct the Project
The intervention for this project involves implementing a sepsis identification and
treatment bundle protocol, including early recognition, timely administration of antibiotics, fluid
resuscitation, and close monitoring of vital signs. Evidence supporting this intervention comes
from reputable organizations such as the Centers for Disease Control and Prevention (CDC) and
research articles from peer-reviewed journals. The CDC's Sepsis Toolkit provides guidance on
early recognition and treatment (2018), while research articles by Singer et al. (2016) and
Rhodes et al. (2017) offer consensus definitions and international guidelines for sepsis
management.
Outcomes
To determine the success of the intervention, several outcomes will be measured. These
include a reduction in the time to antibiotic administration, a decrease in mortality rates
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