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Evaluating the impact of end-tidal carbon dioxide monitoring in emergency department sepsis patients
Descriptive
TitleInfo
Title
Evaluating the impact of end-tidal carbon dioxide monitoring in emergency department sepsis patients
Name
(type = personal)
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(type = family)
Gallant
NamePart
(type = given)
Stephanie L.
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1984-
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Stephanie L. Gallant
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(authority = RULIB)
author
Name
(type = personal)
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(type = family)
Kamienski
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(type = given)
Mary
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Mary Kamienski
Affiliation
Advisory Committee
Role
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(authority = RULIB)
chair
Name
(type = personal)
NamePart
(type = family)
Evanovich Zavotsky
NamePart
(type = given)
Kathleen
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Kathleen Evanovich Zavotsky
Affiliation
Advisory Committee
Role
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(authority = RULIB)
outside member
Name
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Rutgers University
Role
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(authority = RULIB)
degree grantor
Name
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NamePart
School of Nursing - RBHS
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school
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Text
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theses
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2019
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2019-05
Language
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English
Abstract
(type = abstract)
Severe sepsis and septic shock remain significant international health burdens with high mortalities and financial implications. Rapid identification of the septic patient is imperative as compliance with guideline-recommended, time-specific bundles has been shown to decrease sepsis-related mortality. Despite this, compliance with the bundles remains low. Evidence has suggested that end-tidal carbon dioxide (EtCO2) monitoring may be a viable intervention to aid in overcoming some barriers to sepsis identification and initiation of treatment.
The purpose of this project was to evaluate whether the use of end-tidal carbon dioxide (EtCO2) monitoring in patients being evaluated for sepsis in the adult emergency department will result in decreased time to recognition and time to antibiotics, and increased bundle compliance, including overall, antibiotic, and intravenous fluid compliance, as compared to those who do not receive EtCO2 monitoring.
Using the Ottawa Model of Research Use as a conceptual model, this project consisted of a pilot evaluation of EtCO2 monitoring as part of an existing Code Sepsis response, followed by aggregate data review. Time to antibiotics and recognition, percent of patients receiving antibiotics in three hours, and total bundle compliance increased, while the percent of patients receiving appropriate intravenous fluids decreased. None of these results showed statistical significance. The results of the pilot evaluation do not support the addition or removal of EtCO2 monitoring. There are several indications for future research, including a longer evaluation time and evaluating potential confounders.
The purpose of this project was to evaluate whether the use of end-tidal carbon dioxide (EtCO2) monitoring in patients being evaluated for sepsis in the adult emergency department will result in decreased time to recognition and time to antibiotics, and increased bundle compliance, including overall, antibiotic, and intravenous fluid compliance, as compared to those who do not receive EtCO2 monitoring.
Using the Ottawa Model of Research Use as a conceptual model, this project consisted of a pilot evaluation of EtCO2 monitoring as part of an existing Code Sepsis response, followed by aggregate data review. Time to antibiotics and recognition, percent of patients receiving antibiotics in three hours, and total bundle compliance increased, while the percent of patients receiving appropriate intravenous fluids decreased. None of these results showed statistical significance. The results of the pilot evaluation do not support the addition or removal of EtCO2 monitoring. There are several indications for future research, including a longer evaluation time and evaluating potential confounders.
Subject
(authority = RUETD)
Topic
Family Nurse Practitioner in Emergency Care
Subject
(authority = local)
Topic
End-tidal carbon dioxide monitoring
Subject
(authority = LCSH)
Topic
Respiratory gas monitoring
Subject
(authority = LCSH)
Topic
Septicemia
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Rutgers University Electronic Theses and Dissertations
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ETD_9831
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application/pdf
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text/xml
Extent
1 online resource (56 pages) : illustrations
Note
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DNP
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Includes bibliographical references
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School of Nursing (RBHS) DNP Projects
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rucore10004500001
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NjNbRU
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doi:10.7282/t3-cge4-5m32
Genre
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ETD doctoral
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Rights
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The author owns the copyright to this work.
RightsHolder
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Name
FamilyName
Gallant
GivenName
Stephanie
MiddleName
L.
Role
Copyright Holder
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Type
Permission or license
DateTime
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2019-04-12 10:03:39
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Name
Stephanie Gallant
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Copyright holder
Affiliation
Rutgers University. School of Nursing - RBHS
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License
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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.
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Embargo
DateTime
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2019-05-31
DateTime
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2021-05-30
Detail
Access to this PDF has been restricted at the author's request. It will be publicly available after May 30th, 2021.
Copyright
Status
Copyright protected
Availability
Status
Open
Reason
Permission or license
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2019-08-29T17:12:09
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