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Enhancing Early Sepsis Recognition to Reduce Mortality in Surgical Patients

This project addresses the critical issue of septic shock in surgical patients, which has historically been associated with high mortality due to late recognition. Our goal is to decrease mortality rates by improving the early recognition of sepsis through a collaborative multidisciplinary approach. The initiative includes education for nursing staff, adapting policies and algorithms, and implementing effective communication tools like SBAR. With strong support from hospital administration and identified champions in various departments, we aim to foster a robust response to sepsis, ensuring our surgical patients thrive.

christen-dixon
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Enhancing Early Sepsis Recognition to Reduce Mortality in Surgical Patients

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Presentation Transcript

  1. Team Photo Slide

  2. How are we Surviving Sepsis? TMH ICU Collaborative PDSA Model for Improvement

  3. PlanNeed for Change • Problem: Septic shock in surgical patients had high mortality • Reason: Recognition came too late • Goal: Decrease mortality by improving early recognition of sepsis in surgical patients • Measure: Incidence of septic shock and mortality related to septic shock in surgical patients

  4. Plan • Barriers • Education complexities: Large numbers/Multiple Disciplines • Modify: ED/Critical Care process for Med Surg areas • Empower: Nurses to obtain rapid treatment for their patients • Coverage: Limitations

  5. Plan • Multidisciplinary Team • ICU collaborative members • Hospital Administration support • CPPD • Nurse managers • Physicians • Quality department • Nurse champions • Lab personnel • Informatics • Identified champions for every area

  6. DO • Adapted education used for ED/Critical Care for pilot unit (surgical unit…. Dec./January) • Created a policy and algorithm adapted from ED • Provided unit based tools • Definitions • Algorithm with sepsis bundles • Sample SBAR to physicians for nurses • Badge cards

  7. Badge CardFront & Back

  8. StudyThe Results Data collected by NSQIP and shared with ICU Collaborative

  9. StudyLessons Learned • Education spread to all units, physician/LIP groups (Jan-April) • Shift to shift SBAR has sepsis screen included • Included sepsis in RRT activation criteria • Reinforced in education for RRT start up Tubes for lactate stocked on units • Order sets created • Links to SSC added to nursing & medical websites

  10. ACTNext Steps • Continue to reinforce education • Routinely one on one • Presentation and case studies • Include in orientation • Online education • Module for Brown Students • Consider yearly competencies for nursing • Continue to analyze NSQIP data and integrate into departmental QI, M&M, ICU collaborative • Concurrent chart review • Need better follow up on some Pts ( +sepsis screen but not severe sepsis or shock or not really septic) • Abg lab will go online soon • Pt family education?

  11. How are we Surviving Sepsis? Our surgical patients would have to say… “VERY WELL, THANK YOU!”

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