Date of Award
Final DNP Paper
Doctor of Nursing Practice (DNP) in Adult-Gerontology Acute Care Nurse Practitioner
Timothy Blake Booth, DNP, RN, CNL, CCRN
Stephanie W. Jones, DNP, RN, NE-BC
Brian Keith Brooks, PhD, MSN, MBA-HCM, RN
Background: The Doctor of Nursing Practice (DNP) project focused on the delay in intravenous fluid (IVF) resuscitation of sepsis and septic shock patients in the emergency room (ER) before inpatient admission.
Purpose: The purpose of this project was to improve the time-sensitive administration of IVF resuscitation of adult patients diagnosed with sepsis or septic shock by enhancing ER nurses’ end-user knowledge of and adherence to evidence-based sepsis treatment recommendations over approximately six weeks (42 days).
Methods: Retrospective chart reviews were performed in December 2021 and focused on IVF resuscitation times. Pre-intervention questionnaires were completed, assessing baseline nursing knowledge. Nurse education focused on rapid IVF initiation and the importance of minimizing delays in IVF resuscitation treatment. Participating nurses were educated on the Surviving Sepsis Campaign’s hour-1 bundle protocol. Post-intervention questionnaires were completed, followed by retrospective post-intervention chart reviews in February through March 2022 to evaluate interventional impact.
Results: Pre-intervention retrospective chart reviews revealed 37.3% fallout of sepsis cases regarding IVF resuscitation times compared to 36.8% fallout of sepsis cases post-intervention, a difference of 0.5%. Fisher’s exact test was utilized to test for statistical significance, revealing no statistical significance (p-value = 1.0000).
Conclusion: This project emphasizes the importance of nurse adherence to the sepsis hour-1 bundle protocol of decreasing IVF resuscitation times in hypoperfused sepsis and septic shock patients.
Douglas, Alison, "Improving Intravenous Fluid Resuscitation Compliance of Severe Septic and Septic Shock Adults in a Rural Emergency Room" (2022). Doctor of Nursing Practice Projects. 62.