Evaluation of an Interprofessional Emergency Department Sepsis Quality Improvement Initiative

Purpose: Utilizing the 2016 Surviving Sepsis Campaign guidelines to frame appropriate interventions, the purpose of this scholarly practice project is to evaluate the outcomes of an interprofessional sepsis quality improvement initiative in the ED.
Project Question: Does the implementation of an interprofessional ED sepsis quality improvement initiative increase 3-hour bundle compliance and decrease all-cause in-hospital mortality for ED patients with a sepsis alert activated?
Setting and sample: The project was conducted at a rural, academic, safety-net, level 1 trauma center with approximately 60,000 ED visits per year. The sample included 525 patients, aged 18 years and older, between July and December 2017 who had a sepsis alert activated.
Measures: Adherence to the 3-hour bundle elements of care and all-cause in-hospital mortality.
Method: A prospective, descriptive project evaluating the effect of the sepsis quality improvement initiative over six months.
Procedures: The interprofessional, ED quality improvement team consisted of 11 professionals, who collaborated through 6 formal meetings in a 6-month period. Collected data included demographics, throughput metrics, 3-hour bundle components and mortality.
Results: Over the project period, the mean door to sepsis alert time decreased by 37 minutes. Adherence improved to 3 of the 4 major elements of the 3-hour sepsis management bundle. Month-to-month analysis of mortality data did not demonstrate any significant changes during
the project period.
Nursing implications: This quality improvement initiative empowered nursing staff to screen patients for sepsis, activate sepsis alerts, and initiate bundled care as appropriate.