Sepsis Project Saving Lives
A project at Avera has succeeded in reducing sepsis mortality by 45 percent to an average mortality rate of 8.8 percent – well below the national average of about 14 percent.
Sepsis, the rapid onset of organ dysfunction caused by an overwhelming immune response to infection, accounts for one in five hospital deaths nationwide and kills 258,000 Americans annually. Sepsis not only puts patients at risk, but it also puts hospitals at risk with longer lengths of stay and higher 30-day mortality rates, which can threaten Medicare’s incentive payments under value-based purchasing.
An Avera-wide quality work group has improved its sepsis rates through a project called “Seeing Sepsis,” in which front-line caregivers can quickly identify patients and ensure they get the necessary treatment – fast. This project was done in alliance with the Minnesota Hospital Association.
“Treatment with antibiotics is most effective within the first hour of the onset of sepsis. For every hour that goes by, there’s a 7 percent increase in mortality,” said Dawn Tomac, RN, Director of Clinical Quality Initiatives for Avera Health.
There are multiple steps to “Seeing Sepsis” to ensure its success.
1) A nurse-driven screening protocol that’s hardwired to the electronic medical record. Evidence-based order sets. Antibiotics are listed in order of which to give first for the site of infection, rather than alphabetical order.
2) A transfer trigger tool, to help caregivers know exactly when patients should be transferred to ICU or a tertiary care center.
3) Education. This included videos and an easy-to-follow 100-100-100 infographic created by the Minnesota Hospital Association to use in early sepsis identification.
4) Measurement and feedback ensure that sepsis mortality rates continue to improve.
“The bottom line is that more patients are surviving sepsis at Avera. This is the result of the hard work of hundreds of employees,” says Tomac.