Proffitt Robin D, Hooper Gwendolyn
Clinical Education Department, Ballad Health, Johnson City, Tennessee (Dr Proffitt); and Capstone College of Nursing, The University of Alabama, Tuscaloosa (Dr Hooper).
Adv Emerg Nurs J. 2020 Jan/Mar;42(1):54-62. doi: 10.1097/TME.0000000000000281.
In the emergency department (ED) setting, nurses perform the initial evaluation of patients, thereby placing ED nurses in a prime position to recognize sepsis and greatly influence prompt implementation of treatment. The quick Sequential Organ Failure Assessment (qSOFA) tool was first introduced as part of the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) as a predictor of both increased mortality and longer intensive care unit (ICU) stays. Designed for use outside the ICU, the qSOFA tool functions as a simple bedside tool to quickly identify patients at risk for developing sepsis. As a method to improve detection of sepsis in the ED, an evidence-based screening tool based on the qSOFA criteria was developed. The project implemented over a 14-day period resulted in 106 surveys. Average time from patients entering the ED to actual triage evaluation was 13 min, and the median time from the completion of triage evaluation to the completion of the qSOFA screening tool was 4 min. To determine acceptance of the qSOFA tool for use in detecting sepsis in the ED, a second aim was to evaluate ED nurses' perceptions of the effectiveness, timeliness, and ease of use of the qSOFA evaluation tool. Anonymous postsurvey results revealed that participants were moderately familiar with the qSOFA tool and found it overall easy to complete. The majority of participants stated only a slight likelihood of using the qSOFA tool if it were implemented into clinical practice.
在急诊科，护士对患者进行初步评估，因此急诊科护士处于识别脓毒症的首要位置，并对及时实施治疗有很大影响。快速序贯器官衰竭评估（qSOFA）工具最初作为脓毒症和脓毒性休克第三次国际共识定义（Sepsis-3）的一部分被引入，作为死亡率增加和重症监护病房（ICU）住院时间延长的预测指标。qSOFA工具设计用于ICU之外，是一种简单的床边工具，用于快速识别有发生脓毒症风险的患者。作为一种改善急诊科脓毒症检测的方法，开发了一种基于qSOFA标准的循证筛查工具。该项目在14天内实施，共进行了106次调查。患者从进入急诊科到实际分诊评估的平均时间为13分钟，从分诊评估完成到完成qSOFA筛查工具的中位时间为4分钟。为了确定qSOFA工具在急诊科用于检测脓毒症的可接受性，第二个目标是评估急诊科护士对qSOFA评估工具的有效性、及时性和易用性的看法。匿名调查结果显示，参与者对qSOFA工具中等熟悉，并发现总体上易于完成。大多数参与者表示，如果qSOFA工具在临床实践中实施，使用的可能性很小。
