Defense Date

7-16-2021

Graduation Date

Summer 8-7-2021

Submission Type

DNP Manuscript

Degree Name

Doctor of Nursing Practice (DNP)

Department

Doctor of Nursing Practice (DNP) Program

School

School of Nursing

Faculty Mentor

Dr. Catherine Johnson

Keywords

electronic sepsis alert, sepsis criteria, machine leaning and sepsis alerts, clinical alerts, clinical decision support, clinical deterioration, quality improvement and program evaluation

Abstract

Sepsis is the most expensive clinical condition to treat, with a very high mortality rate (Torio & Moore, 2016). The goal of sepsis treatment is to intervene as early as possible utilizing established criteria. Several evidence-based approaches in the literature address early identification of sepsis, decreasing sepsis severity and reducing morbidity and mortality. Clinical Decision Support (CDS) are tools within certified electronic health records that provide clinicians with patient-specific knowledge presented at appropriate times that enhance decision-making and improve patient outcomes (Villegas & Moore, 2018). Electronic sepsis alerts are examples of CDS that are developed to monitor changes indicative of sepsis in the patient’s condition and alerting providers to expedite early intervention.

Health care systems have invested millions of dollars in expanding electronic health record tools, including the CDS sepsis alert, in increasing the early identification of sepsis and implement early interventions. Yet, despite all these improvement initiatives, sepsis rates continue to rise. Yet, the opportunity for improving their use is missed due to the lack of evaluation of its effectiveness.

This project was a program evaluation of one health care system’s sepsis CDS and associated improvement initiatives that are focused on the prevention of sepsis among adult medical-surgical patients. The W.K. Kellogg Step by Step Guide to Evaluation (2017) was used to conduct the program evaluation of their sepsis CDS, including electronic sepsis order sets, sepsis education, and an overhead code sepsis process. Despite these initiatives, the organization’s Medicare quality sepsis scores demonstrate that a large percentage of their patients are not receiving evidence-based sepsis care, as documented in the electronic health record (EHR). The analysis and recommendations provide needed information to guide future quality improvements in sepsis care to improve sepsis prevention, improve patient outcomes, and reduce health care costs. The use of systematic program evaluation methods can be used as a strategy to determine the improvement gains from a quality improvement project.

Language

English

Download

Included in

Nursing Commons

COinS