Sepsis Bundle Compliance in the Emergency Department
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Date
2018-05
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The Ohio State University
Abstract
Despite knowledge that sepsis bundle (SB) use is associated with decreased mortality, bundle compliance is often low among Emergency Department (ED) providers. The purpose of this quality improvement project is to assess the perceived barriers, beliefs, and preferences influencing sepsis bundle use among providers in an urban emergency department. The objective is to evaluate the understanding of the SB protocol by ED providers, and their perceptions of the benefits or potential harm for the patient when compliance with this protocol is low. A literature review was completed to analyze current best practice and recommendations. Project design included presenting open-ended discussion questions to a single focus group of ED providers to assess barriers to and knowledge of the SB and the surviving sepsis guidelines. Themes were analyzed following transcription of the discussion.
While most providers were aware of the SB, the majority felt the SB was too long and had too many erroneous orders pre-selected for the provider. Providers felt that choosing the orders separately was then easier than using the SB. Additionally, the group agreed that the SB was often not used because sepsis was just difficult to identify most of the time unless the patient was blatantly ill. Evidence supports the use of bundles to improve consistent application of evidence- based practice in the septic patient. This quality improvement project supports the common barriers throughout the literature including difficult identification of sepsis along with lack of awareness and very little education about the SB and guidelines. Compliance has the potential to be increased through adjustments in the SB orders, and providing education on the importance of using and reviewing the components of the SB.
Keywords: sepsis bundle, compliance, sepsis compliance, emergency department, surviving sepsis, sepsis guidelines, quality improvement
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Keywords
sepsis, sepsis bundle compliance, emergency department