Implementation of a Sepsis Alert to Improve Timely Sepsis Care: A Quality Improvement Project

Background: Sepsis is a leading cause of mortality in the hospital setting and early recognition and treatment is essential.
Objective: The goal of this quality improvement project was to implement an interdisciplinary designed sepsis alert protocol and guideline flowsheet to promote early recognition of sepsis, increase compliance with CMS bundle guidelines, and decrease mortality and length of stay.
Methods: A retrospective chart review was performed on emergency department patients who were diagnosed with severe sepsis or septic shock during a 3-month pre- and post-alert time period. Evaluation included time to interventions, completion of CMS bundle components, mortality rates and length of stay.
Results: The CMS bundle compliance improved from 33.3% in the pre-alert group to 45.5% in the post-alert group, closer to the national average of 51% at the time of this project. There was no significant change in mortality for this cohort, but there was a decrease in mean length of stay.
Conclusions: There was improvement with CMS bundle compliance, demonstrating that quality improvement initiatives can improve patient outcomes. There is still further work to be done to continue to improve sepsis care and ongoing evaluation is recommended.
Implications for Nursing: In the emergency department, nurses are often the first member of the healthcare team to evaluate patients and must be able to recognize potential infection, concern for sepsis and act promptly on these findings.