Date of Award

Summer 2023

Degree Name

Doctor of Nursing Practice (DNP)

Department

Health Professions & Wellness

Faculty Chair

Dr. Megan Hunter Moore

Abstract

Background: Sepsis remains one of the leading causes of death in hospital settings. The doctor of nursing practice (DNP) project demonstrated areas that the hospital is doing satisfactorily with compliance and many areas for improvement within the organization regarding sepsis compliance. The DNP project demonstrated the effectiveness of the sepsis best practice advisory (BPA) tool in increasing sepsis bundle compliance in the emergency department (ED).

Purpose: The purpose of this DNP project is to help aid in the early recognition of sepsis and improve initial lactic acid compliance in a local emergency department. Many tools help with the early recognition of sepsis, including electronic alert systems, standardized order sets, and nurse-initiated protocols. Despite available tools and guidelines, mortality rates remain near 50% for sepsis and septic shock.

Methods: The aims of this DNP project were 1) to increase initial lactic acid compliance, 2) to integrate the component of the Epic sepsis BPA clinical decision support tool, and 3) to educate staff through annual training regarding the importance of the sepsis BPA clinical decision support tool.

Results: This DNP project was implemented over eight weeks, and 334 patients presented with sepsis were included in the analysis. Results suggest that initial lactic acid compliance increased from a baseline of 40% without the utilization of the BPA to 48.3% with the BPA for the eight weeks of project implementation.

Conclusion: Emergency departments can implement tools that improve sepsis bundle compliance to reduce mortality and improve outcomes in patients with sepsis.

Keywords: Sepsis, Emergency Department, Adult, Mortality, Lactic Acid Compliance

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