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Background: Implementation of the Surviving Sepsis Campaign (SSC) guidelines into practice has demonstrated improved outcomes.

Local Problem: Compliance with a sepsis protocol, based on the SSC guidelines, in an urban teaching hospital was below the national average.

Methods: A pre- and posttest intervention design was used to improve clinician knowledge, confidence, and compliance with the protocol.

Interventions: Educational modules were developed on the SSC guidelines and reminder system alerts (RSA) for timely revaluation of patients with sepsis and lactate monitoring were implemented.

Results: A total of 33 (48%) clinicians participated. There was an increase in knowledge, documentation of sepsis reassessment, and serum lactate monitoring. There was an improvement in clinician perceptions following the initiative.

Conclusions: The results demonstrate that education, combined with RSAs, can improve protocol knowledge and compliance.

Competing Interests: The authors declare no conflicts of interest.

Titel:	Quality Improvement to Promote Sepsis Reassessment: The Sepsis Reassessment Protocol Improvement Project (SRPIP).
Autor/in / Beteiligte Person:	DeGregoris, JP ; Bandong, L ; White, T ; Brennan, MM
Zeitschrift:	Journal of nursing care quality, Jg. 38 (2023-04-01), Heft 2, S. 107-113
Veröffentlichung:	2003- : Hagerstown, MD : Lippincott Williams & Wilkins ; <i>Original Publication</i>: Frederick, MD : Aspen Publishers, c1991-, 2023
Medientyp:	academicJournal
ISSN:	1550-5065 (electronic)
DOI:	10.1097/NCQ.0000000000000646
Schlagwort:	Humans Guideline Adherence Lactic Acid Hospitals, Teaching Quality Improvement Sepsis
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article Language: English [J Nurs Care Qual] 2023 Apr-Jun 01; Vol. 38 (2), pp. 107-113. <i>Date of Electronic Publication: </i>2022 Sep 05. MeSH Terms: Quality Improvement* ; Sepsis* ; Humans ; Guideline Adherence ; Lactic Acid ; Hospitals, Teaching References: Singer M, Deutschman CS, Seymour CW, et al. The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA. 2016;315(8):801–810. doi:10.1001/jama.2016.0287. ; National Institutes of Health, National Institute of General Medical Sciences. Sepsis. Published 2018. Accessed October 11, 2019. https://www.nigms.nih.gov/education/Documents/Sepsis.pdf. ; Levy MM, Evans LE, Rhodes A. The Surviving Sepsis Campaign bundle: 2018 update. Crit Care Med. 2018;46(6):997–1000. doi:10.1097/CCM.0000000000003119. ; Drahnak D, Hravnak M, Ren D, Haines A, Tuite P. Scripting nurse communication to improve sepsis care. CNE Series. Medsurg Nurs. 2016;25(4):233–239. ; Society of Critical Care Medicine. Implement and improve. Published 2018. Accessed May 12, 2018. http://www.survivingsepsis.org/Improvement/Pages/default.aspx. ; Linnér A, Sundén-Cullberg J, Johansson L, Hjelmqvist H, Norrby-Teglund A, Treutiger CJ. Short- and long-term mortality in severe sepsis/septic shock in a setting with low antibiotic resistance: a prospective observational study in a Swedish university hospital. Front Public Health. 2013;1:51. doi:10.3389/fpubh.2013.00051. ; American Association of Critical Care Nurses. Nurses on the front line of sepsis. Published 2018. Accessed February 15, 2019. https://www.aacn.org/clinical-resources/sepsis?page=1. ; The Mount Sinai Hospital. About us: The Mount Sinai Hospital. Published 2018. Accessed September 11, 2019. https://www.mountsinai.org. ; Medicare.gov. Hospital Compare. Timely and effective care: sepsis care-details. Published 2018. Accessed December 15, 2018. https://www.medicare.gov/hospitalcompare/profile.html#profTab=2&vwgrph=1&ID=330024&loc=10029&lat=40.7916407&lng=-73.9447994&name=MOUNT%20SINAI%20HOSPITAL&Distn=0.6. ; Rau J. Medicare penalizes group of 751 hospitals for patient injuries. Kaiser Health News. December 21, 2017. Accessed March 2018. https://khn.org/news/medicare-penalizes-group-of-751-hospitals-for-patient-injuries. ; Straus S, Glasziou P, Richardson WS, Haynes RB. Evidence-Based Medicine: How to Practice and Teach It. 4th ed. Churchill Livingstone Elsevier; 2019. ; Gatewood MO, Wemple M, Greco S, Kritek PA, Durvasula R. A quality improvement project to improve early sepsis care in the emergency department. BMJ Qual Saf. 2015;24(12):787–795. doi:10.1136/bmjqs-2014-003552. ; O'Shaughnessy J, Grzelak M, Dontsova A, Braun-Alfano I. Early sepsis identification. Medsurg Nurs. 2017;26(4):248–252. ; Rothman M, Levy M, Dellinger RP, et al. Sepsis as 2 problems: identifying sepsis at admission and predicting onset in the hospital using an electronic medical record-based acuity score. J Crit Care. 2016;38:237–244. doi.org/10.1016/j.jcrc.2016.11.037. ; Damiani E, Donati A, Serafini G, et al. Effect of performance improvement programs on compliance with sepsis bundles and mortality: a systematic review and meta-analysis of observational studies. PLoS One. 2015;10(5):e0125827. doi:10.1371/journal.pone.0125827. ; Leach LS, Mayo MA. Rapid response teams: qualitative analysis of their effectiveness. Am J Crit Care. 2013;22(3):1998–1209. doi:10.4037/ajcc2013990. ; Tran N, Coffman JM, Sumino K, Cabana MD. Patient reminder systems and asthma medication adherence: a systematic review. J Asthma. 2014;51(5):536–543. doi:10.3109/02770903.2014.888572. ; Siontis B, Elmer J, Dannielson R, et al. Multifaceted interventions to decrease mortality in patients with severe sepsis/septic shock—a quality improvement project. PeerJ. 2015;3:e1290. doi:10.7717/peerj.1290. ; Nguyen MC, Richardson DM, Hardy SG, et al. Computer-based reminder system effectively impacts physician documentation. Am J Emerg Med. 2014;32(1):104–106. doi:10.1016/j.ajem.2013.10.029. ; Centers for Disease Control and Prevention. CDC evaluation documents, workbooks and tools: logic models. Published 2018. Accessed May 9, 2018. https://www.cdc.gov/eval/tools/logic_models/index.html. ; Palleschi MT, Sirianni S, O'Connor N, Dunn D, Hasenau SM. An interprofessional process to improve early identification and treatment for sepsis. J Healthc Qual. 2014;36(4):23–31. doi:10.1111/jhq.12006. ; Michie S, Atkins L, West R. The Behaviour Change Wheel: A Guide to Designing Interventions. Silverback Publishing; 2014. Substance Nomenclature: 33X04XA5AT (Lactic Acid) Entry Date(s): Date Created: 20220906 Date Completed: 20230224 Latest Revision: 20230920 Update Code: 20240513

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Quality Improvement to Promote Sepsis Reassessment: The Sepsis Reassessment Protocol Improvement Project (SRPIP).