Sepsis:Arresting a Killer

Sunday, 17 November 2013: 11:00 AM

Robyn Weilbacher, RN MSN CNML PCCN
Mercy, St. Louis, MO

Learning Objective 1: To understand differeneces between SIRS, sepsis, severe sepsis and septic shock.To educate on the importance of early identification &action, including a sepsis response team.

Learning Objective 2: The learner will be able to identify key data collection points to measure sepsis bundle complaince as well as the future role of EICU.

Abstract: The Sepsis Resuscitation Project at Mercy Hospital St. Louis began in August of 2011. We recognized the opportunity for vast improvement in outcomes for patients with sepsis. Rapid recognition and aggressive intervention in patients with sepsis dramatically improves outcomes. A pilot study done at 4 Mercy hospitals between 2010 and 2011 demonstrated that no hospital was better than 20% compliant with any sepsis bundle element and the average overall sepsis bundle compliance was 2.3%.
From Nursing Administration and Physician leaders to  bedisde RNs, Mercy took a sweeping global approach to decresing mortality and morbidity as well as decresing LOS in both ICU and hospital stay thereby decreasing cost. Our path:
• Create a multidisciplinary Committee
• Identify improvement opportunities
• Administrative and clinical commitment
• Hospital wide sepsis education: nurses, physicians, pharmacists
• Creation of EPIC Sepsis Pathway
• Creation of Sepsis Resuscitation Team in concert with rapid response Team
• Creation of “virtual sepsis unit"
• Integrate efforts with ED, OR, ICU, Intermediate care, floor services
• Sepsis Report Card to monitor and improve best practice compliance
• Weekly case review
• Coordinate efforts with Critical Care Nursing to ensure immediate ICU bed availability
• Rapid recognition and early intervention efforts
• Sepsis research and quality improvement
We have made substantial improvements in compliance with the sepsis resuscitation bundle. Our mortality in patients with severe sepsis and septic shock has dramatically improved. Compliance with individual sepsis bundle elements has improved. The average length of ICU stay for patients with severe sepsis and septic shock has dropped significantly.
The importance of the multidisciplinary, multiprofessional nature of this project cannot be over emphasized. Physician, nurse and pharmacy champions are needed to make the project successful. Weekly meetings focus activities and maintain momentum. At this point in time the Virtual Sepsis unit is just coming on line.