Nurse-led program cuts sepsis deaths in half

A nurse-led fast-track sepsis screening and diagnosis program cut mortality rates in half at nine California hospitals.

As a condition that almost always leads to longer length of stay and often death, severe sepsis occurs in about 750,000 U.S. patients each year, with 28 percent to 50 percent of these patients dying, according to the Agency for Healthcare Research and Quality (AHRQ) Innovations Exchange. However, many hospitals fail to diagnose and treat sepsis in a timely fashion.

The University of San Francisco's Integrated Nurse Leadership Program had nine participating hospitals including San Francisco General Hospital, San Mateo Medical Center and El Camino Hospital. The nearly two-year collaborative project successfully improved mortality rates by 54.5 percent in one year and yielded a healthy 56 percent return on investment, according to the program.

Nurses screened all new patients for sepsis at the time of admission and again at the start of each shift. Patients with at least two signs that could indicate sepsis triggered a fast-track workup to confirm the diagnosis. Those patients diagnosed with sepsis would receive evidence-based treatment. Unit nurses would then continuously monitor the patients at least once per shift.

"What makes this collaborative unique is that the focus of the educational modules was on developing leadership skills among the frontline clinicians, as well as on specific interventions to reduce sepsis," according to the California Hospital Association website on the case study.

The researchers advised other hospitals considering similar collaborations to standardize and automate the care process, as well as ideally holding two meeting per month to analyze and adjust new processes, if necessary.

For more information:
- see the AHRQ article  
- check out the CHA website

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