Emergency Medicine, Stony Brook University Renaissance School of Medicine, Stony Brook, New York, USA
Division of Pulmonary, Critical Care and Sleep Medicine, Stony Brook University Renaissance School of Medicine, Stony Brook, New York, USA.
BMJ Open Qual. 2024 Nov 2;13(4):e002859. doi: 10.1136/bmjoq-2024-002859.
Sepsis is a global healthcare challenge and a leading cause of morbidity and mortality. In the USA, the Centers for Medicare & Medicaid Services has integrated the Severe Sepsis and Septic Shock Management Bundle (SEP-1) into their Core Quality Measures, which has been linked to lower mortality rates. However, SEP-1's multiple bundle elements present compliance challenges without comprehensive education and a collaborative approach involving nurses and providers (attending physicians, resident physicians, nurse practitioners and physician assistants).
We developed a virtual longitudinal, case-based curriculum using Kern's six-step approach to curriculum development and evaluated its effectiveness using the Kirkpatrick model. The curriculum was distributed hospital-wide over a 32-month period.
A total of 3616 responses were received for the Sepsis Case-Based Curriculum modules, with 47% from nurses and 53% from providers. Responses were distributed similarly among medical and surgical specialties, as well as intensive care units. Nurses' responses were 56% correct, and providers' responses were 51% correct. Most respondents expressed a likelihood of applying the learning to their practice and reported increased knowledge of sepsis. Themes from participant feedback indicated that they found the activity informative and applicable to real-world cases. Additionally, the hospital's SEP-1 bundle compliance improved from 71% (Q1 2021) to 80% (Q3 2023) during the study period.
Meeting SEP-1 bundle elements requires a team-based approach involving providers and nurses. Given the busy hospital environment and diverse care providers, a longitudinal, engaging and concise educational curriculum related to real-life scenarios can enhance sepsis and SEP-1 education.
脓毒症是一个全球性的医疗保健挑战，也是发病率和死亡率的主要原因。在美国，医疗保险和医疗补助服务中心将严重脓毒症和脓毒性休克管理包（SEP-1）纳入其核心质量指标，这与降低死亡率有关。然而，SEP-1 的多个捆绑要素如果没有全面的教育和涉及护士和提供者（主治医生、住院医生、执业护士和医师助理）的协作方法，就会带来合规挑战。
我们使用 Kern 的六步课程开发方法开发了一个虚拟的纵向、基于案例的课程，并使用 Kirkpatrick 模型评估其效果。该课程在 32 个月内全院范围内分发。
总共收到了 3616 份关于脓毒症基于案例的课程模块的回复，其中 47%来自护士，53%来自提供者。医疗和外科专业以及重症监护病房的回复分布相似。护士的回复正确率为 56%，提供者的回复正确率为 51%。大多数受访者表示有可能将所学知识应用于实践，并报告说对脓毒症的了解有所增加。来自参与者反馈的主题表明，他们认为该活动内容丰富，适用于实际案例。此外，在研究期间，医院的 SEP-1 捆绑包的合规性从 71%（2021 年第一季度）提高到 80%（2023 年第三季度）。
满足 SEP-1 捆绑要素需要一个包括提供者和护士的团队方法。鉴于医院繁忙的环境和多样化的护理提供者，一个与现实生活场景相关的、纵向的、引人入胜的和简洁的教育课程可以加强脓毒症和 SEP-1 教育。
