Implementation of the Surviving Sepsis Campaign one-hour bundle in a short stay unit: A quality improvement project.

OBJECTIVE

To improve timely sepsis care by implementing the 2018 Surviving Sepsis Campaign one-hour interventions.

DESIGN

Ten-month prospective quality improvement project.

SETTING

A 38-bed short stay unit within an 800-bed hospital in New York City.

PARTICIPANTS

Patients admitted to the short stay unit who screened positive for sepsis.

INTERVENTION

A sepsis implementation tool was created from the 2018 Surviving Sepsis Campaign guidelines. Sepsis champions delivered education on sepsis recognition, treatment, and management, and the sepsis implementation tool to the healthcare staff.

PROCESS AND OUTCOME MEASURES

Time to first lactate, blood cultures × 2, antibiotic administration, length of stay and mortality were tracked weekly for five months.

RESULTS

From May 6, 2019 to October 1, 2019, 32 patients were diagnosed with sepsis. Initial lactate and blood cultures were completed on every patient within 1one-hour of sepsis diagnosis. Administration of antibiotics within one-hour reached 100% after week four and was sustained.

CONCLUSION

Use of a registered nurse-initiated sepsis implementation tool in a short stay unit led to the completion of blood cultures, initial lactate, and antibiotic administration within one-hour. Key factors to support this practice improvement were increasing registered nurse, physician and physician assistant sepsis knowledge, registered nurse and physician/physician assistant early collaboration, increased staffing and intravenous access equipment.