Purpose: Delayed diagnosis of pediatric sepsis increases morbidity, mortality and healthcare costs. Specific interventions, such as a sepsis screening tool, sepsis huddles, and sepsis management pathway and continuous quality improvement (QI)-based reviews have been shown to decrease time to treatment and mortality. When this project was designed, UNMH did not have any of these interventions in place. This QI project aims to: 1) implement a sepsis screening huddle within 20 minutes when pediatric patients meet a clinical trigger based on vital signs; 2) ensure patients who screen positive for sepsis receive antibiotics within 3 hours; and 3) ensure that patients who screen positive for severe sepsis/septic shock receive antibiotics within 60 minutes. For all measures, the goal is that they occur at least 60% of the time within 9 months of QI project initiation. Methods: The QI project was designed based on the Model for Improvement. The primary QI project measures will be collected via medical record review and assess application of a sepsis screening tool, huddles, management pathway, and treatment. A series of Plan-Do-Study-Act (PDSA) cycles are being conducted to test ways to increase implementation of these interventions. Results: Thus far, the team has completed PDSAs to: develop and finalize a sepsis trigger tool and a Cerner sepsis orderset; develop a huddle (SWARM) script and incorporate feedback from a parent and health literacy; and identify recipients of an automatic Tiger Text for sepsis management. Additional PDSAs are planned to translate the huddle script into Spanish, build the automatic Tiger Text, build a PowerPlan in Cerner, and train clinicians and staff on these tools. Conclusion: PDSAs will continue to test and refine application of a sepsis screening tool, huddles, management pathway, and treatment, and assess impact of the project by examining changes in measures via on-going medical record review.
Duran, Anna; Anjali Subbaswamy; Rachel Tuuri; Sandra Beauman; and Elizabeth Yakes Jimenez. "Improving Sepsis Outcomes in Hospitalized Children Within a Safety Net Hospital: A Quality Improvement Project." (2022). https://digitalrepository.unm.edu/hsc_2022_pediatric_research/10