Date of Award

2016

Document Type

Open Access Dissertation

Department

College of Nursing

Sub-Department

Nursing Practice

First Advisor

Beverly Baliko

Abstract

Sepsis is a condition that arises from the host’s own exaggerated response to an infection, directed towards pathogens, but causing multiple organ failure. Sepsis is one of the most common causes of death, and a considerable absorber of healthcare resources. This frequently fatal condition, despite progress in technology and improving knowledge of pathophysiology, is still poorly understood, carries high mortality and morbidity rates, and survivors are often left with permanent disabilities and poor health outcomes.

Initial presentation of sepsis is often nonspecific, making diagnosis difficult, and causing lifesaving treatment delays. Sepsis guidelines are derived from emerging evidence-based research. While there is a general consensus that the optimal approach to sepsis management is early recognition and rapid intervention, evidence supporting treatment guidelines is evolving and inconsistent. A mandatory quality improvement measure to implement Sepsis Early Management Bundle (SEP-1) went into effect on October 1, 2015, in the settings utilized for this project. An evidence-based project was conducted to evaluate the interventions and the effectiveness of the sepsis protocol on patients’ health outcomes and assess whether implementation of the protocol reflected in reduced hospital length of stay, decreased mortality, morbidity, antibiotics utilization and rehospitalizations in a community hospital in the coastal region of South Carolina. A 19-month data collection, retrospective review, and data analysis included 158 participants in two groups, pre-and post-implementation of the protocol.

Results showed that mortality and hospital stay were considerably reduced after the protocols were implemented; however, readmission rates increased, and morbidity increased. Implementing the mandated protocol actually did not uniformly influence the efficiency of interventions. Results of this study can be used to validate the need for improvement and recommend innovative approaches to therapeutic and diagnostic methods that could facilitate earlier and more targeted interventions.

Future studies are needed to identify approaches that can help sepsis survivors to regain independence, return to prior living arrangements, and avoid rehospitalization. Measures of sepsis guideline effectiveness should focus on not only immediate results and mortality rates, but also return to function and long-term effects affecting survivors.

Rights

© 2016, Monika U. Mróz

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