Nurses Can Help Reduce Sepsis Mortality

An evidence-based nursing protocol can help reduce sepsis mortality rates and increase nurse satisfaction.

Researchers at University of New Mexico Hospitals (Albuquerque, USA) and Great River Health System (Burlington, IA, USA) joined forces to form the Sepsis Mortality Improvement Team (SMITe), which developed several tools to assist nursing staff in the diagnosis and treatment of sepsis. The tools included a screening tool that allows nurses to review sepsis-related symptoms; outlined steps the nurse must take in caring for patient with suspected sepsis; an electronic sepsis order set; and verbal order telephone scripts to support communication between the nurse and the physician.

Through the use of the protocol and the tools developed by the SMITe and staff educators, the nurses were able to recognize patients with sepsis, order laboratory tests, and initiate treatment. Daily patient reports were held between a dedicated rapid response team (RRT) and the unit director to support rapid bed placement and initiation of the sepsis protocol. During the first two years after the initiative began, 225 adult patients screened positive for sepsis and less than 112 deaths occurred, representing a 50% decrease in mortality.

Indirectly, the sepsis screening process led to greater nurse satisfaction as reported in satisfaction surveys, which increased from 72% to 78% on the Hospital Consumer Assessment of Healthcare Providers and Systems survey, based on staff ability to identify early signs and symptoms of sepsis, order necessary tests to substantiate a diagnosis of sepsis, and initiate the protocol. The study detailing the new sepsis protocol and the results of its implementation was published in the January/February 2014 issue of MEDSURG Nursing Journal.

“Results of this project indicated nurses can make a significant contribution to patient care by identifying problems, reviewing the literature, and initiating evidence-based protocols,” concluded lead author Kathy Lopez-Bushnell, EdD, MPH, MSN, APRN, director of nursing research at University of New Mexico Hospitals. “Other factors that contributed to the project’s success included the use of a highly functional interdisciplinary group, access to relevant literature, the presence of a strong clinical component, and the funding of the University of New Mexico Hospitals.”

Sepsis is characterized by a whole-body inflammatory state caused by the immune system's response to a serious infection, most commonly bacteria, but also fungi, viruses, and parasites in the blood, urinary tract, lungs, skin, or other tissues. Common symptoms of sepsis include those related to a specific infection, but usually accompanied by high fevers, hot, flushed skin, elevated heart rate, hyperventilation, altered mental status, swelling, and low blood pressure. Sepsis causes millions of deaths globally each year.

Related Links:
University of New Mexico Hospitals
Great River Health System