Nurse-Led Program Reduces Mortality Rates from Sepsis
A new nurse-led sepsis-screening and response program cut mortality rates in half in the nine California hospitals where it was implemented.
About 750,000 patients develop sepsis in U.S. hospitals each year, and as many as half of them die as a result, according to the Agency for Healthcare Research and Quality (AHRQ). The keys to preventing those deaths are timely diagnosis and prompt treatment with antibiotics; a delay of an hour or two can make all the difference. With that in mind, the University of San Francisco's Integrated Nurse Leadership program conducted a nearly two-year project at nine hospitals in the state. It was built around four approaches: sepsis-screening for all patients, fast-track workups to confirm diagnoses, promoting adherence to protocols aimed at prompt and appropriate treatment, and ongoing monitoring.
As part of the program, nurses screened patients for sepsis at admission and at the beginning of each shift. Patients with more than one indication of sepsis received a fast-track workup to confirm the diagnosis, and treatment, as necessary. Nurses then monitored the patients carefully. Over the course of the study, the participating hospitals developed their own methods for ensuring timely diagnosis and treatment, including updated protocols to help physicians select antibiotics, to help nurses track patients' progress, and more.
The results were striking: the program reduced the hospitals' mortality rate from sepsis by 44 percent during the period of the study, which ended in December 2010, and by 54 percent in the following year.