Sepsis Education in Critical Care Transport

Sepsis is a serious medical concern worldwide and becomes rapidly fatal if not identified and treated early in its development (Benedict, 2015; Rhodes et al., 2017; Singer et al., 2016). A review of literature demonstrates clinicians have difficulty recognizing sepsis timely when it is most treatable (Berg et al., 2013; Mikkelsen et al., 2010). Difficulty recognizing sepsis is because: Signs of sepsis mirror other conditions; sepsis does not have a consistent clinical manifestation; there is not a diagnostic test specific for sepsis; and sepsis is always secondary to an infection (Singer et al., 2016). Literature also reveals while education on sepsis is important and necessary, education has limited effects on the identification and treatment of patients with sepsis (Ferrer et al., 2008; Serrano-Smith, Brodnik, & Emch, 2016; Tromp et al., 2010). Still, education promotes awareness, reinforces treatment, and enhances a nurse’s confidence and competence in managing persons with sepsis (Delaney, Friedman, Dolansky, and Fitzpatrick, 2015; Olson, 2015).

MedFlight was the site for this DNP project. MedFlight is a critical care transportation company in Ohio that provides critical care life support during medical transportation by both medical helicopter and mobile intensive care ground vehicle. MedFlight incorporates a scorecard into its quality management system. Part of this scorecard includes four metrics specific to the care of patients who are diagnosed with sepsis and includes: Intravenous fluid bolus, vasopressor use, serum lactate measurement, and antibiotic therapy. Compliance with MedFlight sepsis metrics was lower than expected and this DNP project sought to explore whether a single online education intervention would improve compliance. Findings revealed participants: Scored higher on a post-education test, felt more informed about sepsis, and believed they were better prepared to treat patients with sepsis. Nonetheless compliance with the four sepsis quality metrics was less after the education than it was before the education. This is consistent with other sepsis literature whereby education has a limited effect on a clinician’s ability to detect and manage patients with sepsis. This DNP project adds to the larger body of knowledge because it is specific to critical care transport and addresses quality measures.