Implementing and Evaluating a Nurse-Driven Sepsis Protocol to Mitigate Acute Care Readmissions in an inpatient Rehabilitation Facility

Research Objectives: To mitigate sepsis readmissions.
To improve nursing knowledge, increase clinical confidence, and enhance communication.

Design: Pre and post survey design after 12 weeks

Setting: 58-bed free standing Inpatient Rehabilitation Facility in urban Philadelphia.

Participants: 53 Full-Time Registered Nurses
40 Certified Nursing Assistants
20 Care Providers

Interventions: An educational video was created and embedded into the redcap platform. The video briefly defined sepsis and the ramifications of sepsis on a national level. The video articulated the readmission frequencies on the local sites rehab unit and introduced the sepsis protocol.
After each nurse watched the video, the sepsis protocol was uploaded automatically and available for download. Each aspect of the interventions were tracked within redcap and 100% of nurses who completed the survey watched the video and viewed the protocol. The protocol used a combination of the Systemic Inflammatory Response Syndrome (SIRs) Criteria, Situation, Background, Assessment and Recommendation (SBAR) tool and Surviving Sepsis Campaign treatment guidelines. The SBAR portion of the protocol listed key words for the bedside clinician to use when calling the provider to give an update on the patient status such as “there is a change in the patient’s baseline” and/or “I suspect early sepsis”.

Main Outcome Measures: An overall decrease in readmission frequencies post implementation yet no statistically significant differences between pre and post sepsis knowledge, clinical confidence in caring for a sepsis patient, and care provider to clinician communication.

Results: During the intervention implementation period, there were 13 patients readmitted to an acute care hospital. Post project implementation, the sepsis readmission rate decreased from a median of 5 to median of 4. Of all sepsis readmissions, 55.6% of nurses reported protocol utilization during the readmission process, whereas pre-implementation there was zero utilization of sepsis protocol.

Conclusions: The key findings in this quality improvement project were an overall decrease in readmission frequencies post implementation yet no statistically significant differences between pre and post sepsis knowledge, clinical confidence in caring for a sepsis patient, and care provider to clinician communication.

Author(s) Disclosures: No Conflicts