Implementation of a Coordinated Sepsis Response Team to Improve Time to Sepsis Treatment
Year: 2020
Type: conference-abstract
Abstract: Background: In July 2018, the Emergency Department at the Ann & Robert H. Lurie Children’s Hospital of Chicago identified barriers to timely sepsis care, including inaccessibility of supplies, inadequate task delegation, communication gaps, and lack of urgency. To address barriers, we developed a standardized sepsis response. Objective: To meet the Surviving Sepsis Campaign fluid and antibiotic administration goals by July 2019. Method: Guided by a key-driver diagram, we created a sepsis response team and protocol (Fig. 1) including: (1) huddle over-head calls; (2) defined sepsis team member roles; (3) sepsis resuscitation carts stocked with supplies in order of use; (4) scripted communication tools; and (5) a 30-minute reassessment. In October 2018, nurses and providers received sepsis refresher education before implementation. Direct observations evaluated sepsis response. Fluid and antibiotic administration timeliness was assessed monthly using standard process control charts. Result: During the post-implementation period, timely fluid administration has sustained improvement; improvements in antibiotic administration timeliness are less evident (Fig. 2). Based on observations (34), sepsis carts have arrived within 3 minutes after huddle-call delivering rapid fluid resuscitation supplies and serving as a visual alert to staff that a patient is being treated for sepsis. Clear nurse-physician communication regarding best practice alert fire and pathway selection was noted in 88% of observations. Of the 21 pathway patients, 81% had a reassessment in 30 minutes (median 30; range 12–35 minutes). Conclusion/Implication: Assessing local barriers and creating a coordinated sepsis response has better-aligned resources and sustained improvements in timely fluid administration in the Emergency Department.Fig. 1.: Sepsis response team protocol.Fig. 2.: Median time of delivery of antibiotics and first fluid bolus from physiologic sepsis.
Source: Pediatric Quality and Safety
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W3047885455