Sunday, 17 November 2019
Abstract
Background Sepsis is a serious medical condition that is caused by an overwhelming immune response to infection. Severe sepsis and septic shock can lead to organ damage and increased mortality which is one of the leading causes of death among hospitalized patients.
Objectives The goal of this project was to improve patient and organizational outcomes, including reducing 30-day readmission rates with the use of an evidence-based sepsis bundle and staff and patient education.
Methods An observational cohort study of adults (aged 18 and above) admitted to an acute care hospital was conducted. Upon identification of sepsis criteria, a predefined sepsis bundle was initiated through the EMR system. Patients who met inclusion criteria were followed through their stay and given detailed discharge instructions by a sepsis education team. Multiple variables were tracked upon discharge and recorded through retrospective review. Readmission status, suspected cause of sepsis, discharge disposition, and bundle compliance was tracked and analyzed using IBM SPSS version 22.
Results Data were collected on 100 patients (mean [SD] age, 57.16 [19.54] years) pre-intervention and 100 patients (mean [SD] age, 59.41 [18.38] years) post-intervention. Data showed 100% antibiotic compliance and an overall improvement from the pre-(N=100) and post-intervention (N=100) antibiotic time (58% vs 67%), intravenous fluid administration (81% vs 90%), and obtaining a procalcitonin (83% vs 91%). Discharge education improved in the post-intervention group (67% vs 86%). A chi-square of disposition and cause of sepsis in both pre- and post-intervention samples was completed which did not reveal a statistically significant difference either pre-intervention (Ҳ2(4) = 4.993, p = .294) or post-intervention (Ҳ246) = 2.981, p = .561). However, clinical trends were noted. The results found that 42% of the total population were admitted with a genitourinary source of sepsis. Within this group, nine patients readmitted within 30 days compared to pneumonia (with 11 readmissions among 23.5% of the total population). The other 34.5% of the total sample had suspected causes of skin or bone infections, gastrointestinal infection, or unknown/other cause.
Conclusion In a small acute care facility, adherence to a sepsis bundle and implementation of educational components for nurses and patients was associated with a decreased readmission rate.
Background Sepsis is a serious medical condition that is caused by an overwhelming immune response to infection. Severe sepsis and septic shock can lead to organ damage and increased mortality which is one of the leading causes of death among hospitalized patients.
Objectives The goal of this project was to improve patient and organizational outcomes, including reducing 30-day readmission rates with the use of an evidence-based sepsis bundle and staff and patient education.
Methods An observational cohort study of adults (aged 18 and above) admitted to an acute care hospital was conducted. Upon identification of sepsis criteria, a predefined sepsis bundle was initiated through the EMR system. Patients who met inclusion criteria were followed through their stay and given detailed discharge instructions by a sepsis education team. Multiple variables were tracked upon discharge and recorded through retrospective review. Readmission status, suspected cause of sepsis, discharge disposition, and bundle compliance was tracked and analyzed using IBM SPSS version 22.
Results Data were collected on 100 patients (mean [SD] age, 57.16 [19.54] years) pre-intervention and 100 patients (mean [SD] age, 59.41 [18.38] years) post-intervention. Data showed 100% antibiotic compliance and an overall improvement from the pre-(N=100) and post-intervention (N=100) antibiotic time (58% vs 67%), intravenous fluid administration (81% vs 90%), and obtaining a procalcitonin (83% vs 91%). Discharge education improved in the post-intervention group (67% vs 86%). A chi-square of disposition and cause of sepsis in both pre- and post-intervention samples was completed which did not reveal a statistically significant difference either pre-intervention (Ҳ2(4) = 4.993, p = .294) or post-intervention (Ҳ246) = 2.981, p = .561). However, clinical trends were noted. The results found that 42% of the total population were admitted with a genitourinary source of sepsis. Within this group, nine patients readmitted within 30 days compared to pneumonia (with 11 readmissions among 23.5% of the total population). The other 34.5% of the total sample had suspected causes of skin or bone infections, gastrointestinal infection, or unknown/other cause.
Conclusion In a small acute care facility, adherence to a sepsis bundle and implementation of educational components for nurses and patients was associated with a decreased readmission rate.
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