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Sepsis: an evaluation of the effectiveness of an electronic sepsis surveillance in medical/surgical units

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TitleInfo
Title
Sepsis: an evaluation of the effectiveness of an electronic sepsis surveillance in medical/surgical units
Name (type = personal)
NamePart (type = family)
Piech
NamePart (type = given)
Lauren
NamePart (type = date)
1984-
DisplayForm
Lauren Piech
Role
RoleTerm (authority = RULIB)
author
Name (type = personal)
NamePart (type = family)
Cadmus
NamePart (type = given)
Edna
DisplayForm
Edna Cadmus
Affiliation
Advisory Committee
Role
RoleTerm (authority = RULIB)
chair
Name (type = corporate)
NamePart
Rutgers University
Role
RoleTerm (authority = RULIB)
degree grantor
Name (type = corporate)
NamePart
School of Nursing - RBHS
Role
RoleTerm (authority = RULIB)
school
TypeOfResource
Text
Genre (authority = marcgt)
theses
OriginInfo
DateCreated (qualifier = exact)
2019
DateOther (qualifier = exact); (type = degree)
2019-01
CopyrightDate (encoding = w3cdtf); (qualifier = exact)
2019
Language
LanguageTerm (authority = ISO 639-3:2007); (type = text)
English
Abstract (type = abstract)
PURPOSE: Early identification of septic patients is important for early treatment, reduction of length of stay and mortality, and reduction of costs. Early identification processes should leverage functionality of the electronic medical record to automate identification and notification to healthcare providers in order to reassess the patient and start treatment if necessary. A community hospital in Northern New Jersey implemented an electronic sepsis surveillance board that automatically qualified patients based on SIRS criteria in 2015, but had not completed any analysis surrounding the surveillance board or the process. Once qualified, the primary nurse is to take a second set of vital signs and the rapid response nurse is to evaluate the patient to determine if further interventions are necessary. The purpose of this project was to evaluate the compliance surrounding the process for an electronic sepsis surveillance board.

METHODOLOGY: A retrospective, closed chart review was completed for patients that qualified between January 1st, 2017 to June 30th, 2018 in six medical/surgical and two cardiac/telemetry units. An analytics tool was used to create the analysis regarding compliance for obtaining a second set of vital signs, rapid response team interventions, and overall qualification reasons and time on the electronic sepsis surveillance board.

RESULTS: During the analysis period, 3,491 patients (n=3,491) qualified on the electronic sepsis surveillance board, totaling of 9,602 qualifications and 2.3 average number of qualifications per patient. Patients were on the electronic sepsis surveillance board for an average of 196.6 minutes. Overall compliance to documentation of the required second set of vital signs was 71.4%, with a mean time to documentation at 8 hours 1 minute. False positives were not able to be analyzed due to the length of time to obtain a full set of vital signs. Overall compliance to documentation by the rapid response team was 35.4%, with the mean time to documentation of 1 hour 7 minutes, with higher compliance to documentation during the day shift.

IMPLICATIONS FOR PRACTICE: This project supports the need for continued analysis regarding the process surrounding early identification and treatment of potentially septic patients. Without the analysis, the organization would not have identified that there was not a policy defining the process, that a full set of vital signs was not being documented in the defined period, and that documentation was not occurring in real time. Reinforcement needs to be done regarding timely assessment of patients. Technology needs to be evaluated on how it can assist staff in obtaining real time documentation and alerting of potentially septic patients. The organization must also create ways to share compliance rates with staff in order to increase awareness and improve compliance with the process. Implications for future research include analysis on patient outcomes once the time to documentation is reduced.
Subject (authority = RUETD)
Topic
Post-Master's DNP Leadership
Subject (authority = ETD-LCSH)
Topic
Septicemia -- Diagnosis
RelatedItem (type = host)
TitleInfo
Title
Rutgers University Electronic Theses and Dissertations
Identifier (type = RULIB)
ETD
RelatedItem (type = host)
TitleInfo
Title
School of Nursing (RBHS) DNP Projects
Identifier (type = local)
rucore10004500001
Identifier
ETD_9550
Identifier (type = doi)
doi:10.7282/t3-3605-1z76
PhysicalDescription
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application/pdf
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text/xml
Extent
1 online resource (80 pages) : illustrations
Note (type = degree)
DNP
Note (type = bibliography)
Includes bibliographical references
Location
PhysicalLocation (authority = marcorg); (displayLabel = Rutgers, The State University of New Jersey)
NjNbRU
Genre (authority = ExL-Esploro)
ETD doctoral
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Rights

RightsDeclaration (ID = rulibRdec0006)
The author owns the copyright to this work.
RightsHolder (type = personal)
Name
FamilyName
Piech
GivenName
Lauren
Role
Copyright Holder
RightsEvent
Type
Permission or license
DateTime (encoding = w3cdtf); (qualifier = exact); (point = start)
2019-02-03 10:48:24
AssociatedEntity
Name
Lauren Piech
Role
Copyright holder
Affiliation
Rutgers University. School of Nursing - RBHS
AssociatedObject
Type
License
Name
Author Agreement License
Detail
I hereby grant to the Rutgers University Libraries and to my school the non-exclusive right to archive, reproduce and distribute my thesis or dissertation, in whole or in part, and/or my abstract, in whole or in part, in and from an electronic format, subject to the release date subsequently stipulated in this submittal form and approved by my school. I represent and stipulate that the thesis or dissertation and its abstract are my original work, that they do not infringe or violate any rights of others, and that I make these grants as the sole owner of the rights to my thesis or dissertation and its abstract. I represent that I have obtained written permissions, when necessary, from the owner(s) of each third party copyrighted matter to be included in my thesis or dissertation and will supply copies of such upon request by my school. I acknowledge that RU ETD and my school will not distribute my thesis or dissertation or its abstract if, in their reasonable judgment, they believe all such rights have not been secured. I acknowledge that I retain ownership rights to the copyright of my work. I also retain the right to use all or part of this thesis or dissertation in future works, such as articles or books.
RightsEvent
Type
Embargo
DateTime (encoding = w3cdtf); (qualifier = exact); (point = start)
2019-01-31
DateTime (encoding = w3cdtf); (qualifier = exact); (point = end)
2099-12-31
Detail
Access to this PDF has been restricted at the author's request.
Copyright
Status
Copyright protected
Availability
Status
Open
Reason
Permission or license
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Technical

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DateCreated (point = end); (encoding = w3cdtf); (qualifier = exact)
2019-02-03T10:41:58
DateCreated (point = end); (encoding = w3cdtf); (qualifier = exact)
2019-02-03T10:41:58
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