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Learning Objective 1: The learner will be able to describe patient selection and treatment protocols, including early goal directed therapy, for patients with severe sepsis and septic shock.
Learning Objective 2: The learner will be able to identify strategies to improve compliance with elements of a six and twenty-four hour sepsis care bundle.
This session will outline evidence-based management of patients with sepsis. Successful practices to decrease mortality will be detailed. The target audience includes hospital executives and directors, Advanced Practice Nurses, individuals with responsibility for implementing performance improvement strategies, and direct care providers.
An internal mortality review conducted in Kaiser Permanente Northern California (KPNC) medical centers identified Sepsis as the number one cause of inpatient mortality. Clinical studies conducted by Emmanuel Rivers, MD and others have demonstrated that Early Goal Directed Therapy (EGDT) improves outcomes and decreases mortality in patients with severe sepsis and septic shock. In 2009 an evidence based protocol for EGDT was implemented across all KPNC medical centers. Utilizing the Institute for Healthcare Improvement’s (IHI) Model for Improvement a comprehensive performance improvement program was developed to be implemented at all KPNC medical centers. A “Collaborative” was formed to facilitate sharing of knowledge, best practices, and successful performance improvement strategies. Additionally a steering group of quality leaders, physicians, nurse leaders, and performance improvement experts was convened. This group established program objectives and performance targets, learning needs, and appointed champions and clinical leads. The group meets on an ongoing basis to track performance, set ongoing performance improvement targets, and refine action plans to improve practice and achieve results. An “Improvement Advisor” with specialized training in performance improvement methods was established at each medical center. The improvement advisors are instrumental in conducting real time analysis of performance, collating and sharing data, and drive performance utilizing rapid improvement methodology including small tests of change and plan-do-study-act (PDSA) cycles. The Sepsis Collaborative Initiative has resulted in significantly decreased mortality, improved recognition and treatment of patients with severe sepsis and septic shock, better compliance with the EGDT bundle elements, and decreased hospital length of stay for patients with sepsis.
See more of: Oral Paper & Poster: Evidence-Based Practice Contest