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Monday, November 5, 2007

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This presentation is part of : Innovations in Clinical Excellence Evidence-Based Practice Contest Winners I
Decreasing Sepsis Mortality through International Evidence-Based Practice Collaboration
Diane E. White, Georgia Baptist College of Nursing of Mercer University, Atlanta, GA, USA
Learning Objective #1: identify at least 3 international resources available for developing and implementing a successful sepsis bundle to decrease sepsis mortality.
Learning Objective #2: state 2 reasons that international collaboration enhances evidence-based practice.

 

 

 

 

 

 

An epidemic of sepsis mortality exists worldwide. In 2002, the Surviving Sepsis Campaign was formed in an effort to decrease international sepsis mortality rates. This campaign allowed international collaborative research to be conducted towards an effort to decrease sepsis mortality by 25%. In 2004 evidence gathered from international resources was used to formulate a sepsis bundle for use in a community hospital outside a large Southeastern Metropolitan city. The evidence was obtained using literature reviews, chart reviews, and collaborative meetings with the Institute for Healthcare Improvement (IHI). Synthesis of the information was completed by an interprofessional team consisting of nursing and non-nursing members. A goal of decreasing sepsis mortality and thereby increasing the hospital's health grade from a 1 to 3- star was determined by the team. The plan was to create a sepsis bundle that would help achieve the goal. The sepsis bundle included defining severe sepsis and sepsis shock, development of a medical chart evaluation review tool, and the development and implementation of sepsis and blood glucose order sets. The team met monthly and as needed to complete the interventions. After implementation, the team continued to meet to make “on the fly' changes for rapid cycle improvements. Using the IHI's Saving 100,000 lives campaign formula, 31 lives were saved at this institution and there was a 15% decrease in sepsis mortality within one year. These statistics earned the hospital a health grade of 3-star and other hospital awards. Monthly sepsis patient chart reviews continue to be conducted by the critical care collaborative team using the Sepsis MAP tool created from this project. Information from these reviews has assisted the team in revising the sepsis bundle as needed to promote positive patient outcomes. Since this hospital's initiative, other hospitals both nationally and internationally are using the sepsis bundle as a benchmark for best practice.  Many underlying lessons were learned from this international collaborative project; however, the primary lesson learned was that evidence-based practice saves lives.