Title

Surviving Sepsis: A Treatment Process Improvement in High Volume Emergency Departments

Date of Degree

12-2019

Document Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)

Program

Nursing

Advisor

Julio Lujano

Advisor

Stephen McConnell

Abstract

Sepsis is the 3rd leading cause of death in the United States, accounting for approximately 270,000 deaths annually (CDC, 2017). It is the number one cause of death in hospitals, the number one cause of hospital readmissions, and the costliest diagnosis in the hospital setting (Fingar & Washington, 2015; Torio & Andrews, 2015). This quality improvement project aimed to increase the percentage of antibiotics administered within 1 hour for sepsis patients. Mortality rates significantly decrease when this goal is met (Howell & Davis, 2017). There is an 8% increase in mortality risks with every hour that passes with elevated lactic acid and white blood cell counts without treatment (Kumar et al., 2006). Nearly 80% of deaths related to sepsis could be prevented with rapid treatment (Kumar et al., 2006). There was a significant lag in laboratory specimen processing time at two San Antonio, Texas emergency departments. Everything was ordered stat, rendering nothing stat. This was delaying lifesaving treatment for sepsis patients. An ultra-stat method was introduced that encompassed the utilization of a yellow biohazard bag to transport sepsis serum specimens to the laboratory indicating ultra-stat priority processing to improve the result time of laboratory specimens screened as sepsis. The goal was to improve antibiotic administration time for emergency department sepsis patients at these two facilities. Mortality rates and antibiotic delivery times pre- and post-intervention were collected. The results showed that ultra-stat yellow biohazard bag utilization increased antibiotic administration under 1-hour rates and decreased sepsis related mortality.

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