3rd National Sepsis Summit, Dublin castle, 20th Sept '16

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Presentation transcript:

3rd National Sepsis Summit, Dublin castle, 20th Sept '16 Sepsis - Emergency Presentations & Supporting Interventions & Strategies Sarah Watkins Nurse Researcher/Phd candidate 3rd National Sepsis Summit, Dublin castle, 20th Sept '16

Background A retrospective audit 300 samples of nursing records (ADULTS) in the November 2014 Comprehensive assessment Clear articulation of ED nurse’s role Integrated evidence base Tip: Add your own speaker notes here.

Question How did nurses contribute to the emergency service? What were ED nurses doing to help in detecting Sepsis?

ED Nurse Screening to identify patients who have Sepsis Initiating the diagnostic workup Reducing door to needle time for administration of intravenous antibiotics (Bruce et al. 2015, Gatewood et al. 2015) Tip: Add your own speaker notes here.

Objectives Develop a Nursing Proforma Comprehensive Assessment Integration of best evidence Articulate the ED nurse’s role Capture detection rate /important data – time to blood cultures, time to first lactate and time to antimicrobials.

Methods Pilot of Nursing Proforma (Adults) November 2015

Methods NewnursingdocAUG1.pdf

Results Sample : 22 Inclusion Criteria : 10% of all Adult patients who presented with suspicion of or confirmed infection in a 2 week period to ED in UHL. The sample was randomly selected from this criteria. Exclusion Criteria : Paediatric patients, Pregnant women, Post-partum women up to 42 days. Tip: Add your own speaker notes here.

17/22 patients were screened for and correctly identified as Sepsis Results 17/22 patients were screened for and correctly identified as Sepsis 5/22 non compliance

SEPSIS SIX 17 fluids 17 Blood cultures 16 Bloods 15 Antimicrobials 10 Oxygen 07 Urine output

Conclusions Triage Trigger/Trolley Trigger Screening Comprehensive, standardised, evidence based assessment Template for new/inexperienced ED nurses Promotes seamless care transitions

Intellectual disability Acute Services Older people Mental Health Intellectual disability Childrens Midwifery Public Health

Future Plan Emergency Service Sepsis Falls Risk

References Bruce, H.R., Maiden, J., Fedullo, P.F. & Kim, S.C. (2015) ‘Impact of Nurse – Initiated ED Sepsis Protocol on Compliance With Sepsis Bundles, Time to Initial Antibiotic Administration, And In-Hospital Mortality’, Journal of Emergency Nursing, 41(2), p. 130-137. Gatewood, M., Wemple, M., Greco. S., Kritek, P.A. & Durvasula, R. (2015) ‘A quality improvement project to improve early sepsis care in the emergency department’{online]24. Available@http://qualitysafety.bmj.com/content/24/12/787#BIBL[Accessed : 2nd July 2016]. Ireland. HSE (2015) Guiding Framework for the Implementation of Nursing and Midwifery Quality Care Metrics in the Health Service Executive. Dublin:HSE. Ireland. DOH (2014) Sepsis Management National Clinical Guideline No. 6. Dublin: DOH.

Tip: Add your own speaker notes here.