Background: Sepsis is a life threatening medical emergency triggered by an infection and can rapidly lead to tissue damage, organ failure and death. Early identification and treatment can improve mortality by up to 10%. We designed sepsis response team in our hospital to improve mortality index in patients with sepsis.
Purpose: Early recognition and treatment of sepsis is critical to the improve outcomes in the patients. The purpose of this initiative involved educating nursing staff and other members of the team to improve the antibiotic administration time and using standardized order set.
Description: The inpatient Code Sepsis Team was initially designed in 2020 to respond to all the patients suspected to develop sepsis. However the teams were reconstructed in 2022 and a new Code Sepsis documentation flowsheet was created. The new TEAM approach was established to assist with rapid identification and expedited sepsis treatment. The new documentation allows for real time intervention documentation and is a part of the patient’s medical record. The new Code Sepsis Team includes the rapid response nurse, nurse practitioner, phlebotomist, and pharmacist. The “CODE SEPSIS” can be initiated by any person involved in patient care if they suspect sepsis and this team responds to all Code Sepsis calls. The team is set up to expedite the lactate and blood culture draw, timely antibiotic administration (within 1 hour). We also designed order set “MED SEPSIS” in the electronic medical record. Teams were educated to increase utilization of this order set. This contained all the typical antibiotics orders, blood culture orders, lactate orders and other orders that may be needed in a septic patient like chest radiograph. Most importantly this order set will default all the antibiotics to be administered “STAT”, was carried over from one unit to other to prevent delays if patient is moved from one unit to other and will default a repeat lactate draw if initial one was elevated. We also educated nursing staff on identifying sepsis and then subsequently calling a “CODE SEPSIS”. These teams were initiated in all the hospital units including intensive care units, step down units and post procedural units.We also improved documentation of patient comorbidities present on admission and then used standardized models to identify mortality risk from sepsis. This helped us quantify sepsis mortality index (observed: expected). With all the above measures, we have achieved observed: expected mortality of 1.0 so far in the year 2022.
Conclusions: Effective treatment of sepsis needs a multi pronged approach, collaboration between different departments within the hospital and continued education to recognize sepsis early. This approach helped us improve and save multiple lives.