| Sumario: | Significance & Background: Sepsis is a major cause of mortality worldwide. Oncology patients are at higher risk for developing sepsis due to depressed immune system, malnutrition, illness, comorbidities and frailty from age and diagnosis. Sepsis is resource-intensive and requires prompt recognition and treatment to reduce mortality. Centers for Medicare and Medicaid along with Surviving Sepsis Campaign have published well known sepsis bundle elements to promote best patient outcomes. Data on Care Compare.gov for Q4 2023 to Q3 2024 showed a national rate of 63% and state rate in Illinois of 61%. Purpose: To identify evidence-based practice (EBP)/quality improvement interventions to assist with improving this facility's compliance bundle percentage from 53% Q4 2023- Q3 2024 with the CMS and Surviving Sepsis Campaign Bundles by at least 20%. The object was to re-evaluate the multidisciplinary response for the evaluation, resuscitation, and care of the adult oncology patient suspected of having all forms of sepsis and to institute EBP to improve compliance with the bundle items. Interventions: FY 24 data showed a fallout in three of six bundle elements; blood cultures, repeat lactic acid, and perfusion reassessment. Initiate a Nurse driven order set to include: Blood cultures, first lactic acid, and second lactic acid to be completed prior to ED transfer. Initiate perfusion reassessment education for providers. Other evidence-based practices implemented: * Sepsis Champion to lead initiative * Sepsis Alert Rapid Response Team * Sepsis checklist (paper tool) utilization and audits * EHR optimization: Sepsis BPA, nurse driven order panel, standardized physician documentation, standardized physician orders * Monthly multi-disciplinary Sepsis Taskforce Team meeting * Sepsis education for providers and house wide skills fair for nursing staff * Letter to providers for sepsis fallout Results: Showed an increase in sepsis bundle compliance, current FYTD of 75.7% compared to previous FY 53%. There is a significant decrease in the three of six fallouts that were targeted. Discussion: Upon implementation and sustaining the above evidence-based quality improvement interventions, this facility has been able to reach and sustain percentages above national and state average for sepsis intervention. There is monthly ongoing education, discussion, and re-evaluation of Sepsis Protocol to ensure improvements are sustained and best practice is followed. The next challenge is to address the long-term effects of sepsis including promoting recovery and goals of care after discharge.
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