DescriptionPurpose of Project: This project employs a program evaluation strategy to identify gaps in the current sepsis policy and make recommendations for improvement. In engaging stakeholders and key participants, this program evaluation explores barriers and facilitators of sepsis bundle (SEP-1) compliance. SEP-1 is an evidence-based guideline to standardize sepsis management.
Methodology: The CIPP (Context, Inputs, Process, and Product) Model was used to evaluate the current sepsis program at a NJ hospital. Context evaluation used a stakeholder survey to gain perspective on the program’s strengths, weaknesses, and goals. Then, the Inputs evaluation employed an end-user survey to review nursing’s perceived barriers and facilitators of SEP-1 compliance. Process evaluation examined the current process in place by creating an “As-Is” Swimlane diagram. Then, a gap analysis was done to identify specific areas where the current sepsis management policy did not align with the latest Surviving Sepsis Campaign guidelines. Then, the Product evaluation suggested a modified workflow process that filled the gaps found in the gap analysis. Finally, all findings from the program evaluation and literature review are compiled to present a number of recommendations for program improvement.
Results: Overall, this program evaluation was able to measure a significant improvement in sepsis care performance as a result of the QI team’s efforts to improve SEP-1 compliance awareness. An 8% increase in SEP-1 compliance was noted in ED and a 23% increase was noted in inpatient units. Results of the end-user survey concluded that 25% of nurses disagreed that SEP-1 is a priority, 25% did not fully understand their role in sepsis care, and 25% did not think they had appropriate skills/training to provide care for a septic patient. Finally, a gap analysis showed inconsistencies in fluid resuscitation and infection management strategies when comparing the current sepsis management policy to the established guidelines. A list of recommendations was provided at the end, after a rigorous review of the literature and an evaluation of the program.
Implications: This program evaluation was done in conjunction with the hospital’s efforts to improve their sepsis program. Program evaluation initiatives in the healthcare setting allow for valuable feedback from end-users and stakeholders, which lends to a culture of ongoing growth and improvement. There are a number of positive implications to healthcare policy, education, clinical practice, and economic benefit as a result of conducting program evaluations in the healthcare setting.