Stamp out Sepsis: Meridian Call to Action May 2015

Our Story of Loss by Sepsis An18-year-old woman (Janelle*) arrived one evening in a Meridian ER with a fever, a white count of 23.8, lab work indicating renal concerns, a heart rate that had climbed to 120, and a complaint of abdominal pain. On admission to the floor in the middle of the night, she was assessed as lethargic. * fictitious name

Our Story of Loss by Sepsis (continued) Throughout the day and evening, Janelle continued to deteriorate. Renal failure ensued. Disseminated intravascular coagulation developed and GI bleeding occurred. Aggressive treatment including drugs, blood, fluids, dialysis, intubation and mechanical ventilation all were attempted... But it was too late. Janelle died within a day of her arrival in our Meridian ED, on her 19 th birthday.

Our Story of Loss by Sepsis (continued) By early morning, her heart rate continued at the high rate of 130 and now her BP was concerning at 84/40 and her rectal temp was sub-normal. It was not possible to even draw labs on her. Intravenous fluids and antibiotics were given but two hours later, her BP was only 60 and she was transferred to the intensive care unit at 8 a.m.

Our Story of Loss by Sepsis (continued) One of our own nurses noted: “The devastation and heartbreak that was felt by the team that did all they could do for her and couldn’t save her was secondary only to the heartbreak, devastation and anguish of her parents who lost a child that night.”

New Jersey Sepsis Mortality Rate in 2013: 29% By reducing that rate by 20%, 1214 lives would be saved. As such, we are part of a New Jersey collaborative to reduce sepsis mortality  –Bold aims: Implement early recognition sepsis screening and treatment protocols in all NJ hospitals by December 2015 Reduce severe sepsis mortality rates by 20% in NJ by December 2015

Meridian Sepsis Mortality January – December 2014 Sepsis mortality excluding palliative care Data Source: NJHA

Meridian Hospitals Lost 329 Lives to Sepsis in 2014 * * Number excludes palliative care cases

At Meridian, a 20% reduction would mean… 66 people could be saved Janelle could have been one of them…

Are we going where no one has gone before? NO – Look at Kaiser Permanente: Advisory Board “Ten Imperatives to Reduce Sepsis Mortality”

Wake Forest saw Tremendous Improvement

We need a sense of urgency Advisory Board “Ten Imperatives to Reduce Sepsis Mortality”

Education Plans: All coming to a place near you Multi-method: A variety of delivery methods will be used to get information out to bedside clinicians, including but not limited to: Huddles, HealthStream modules, Eye on Evidence newsletters, and webinar. Layered educational processes –Call to Action – Early May 2015 –Core education on sepsis – Mid-May 2015 –Reminders and Refreshers – June through December 2015

Thank you for your commitment to making our patients safer