388 Sepsis Fun Facts: A Simple Way to Increase Sepsis Bundle Compliance

Abstract

To design a quality improvement project to improve sepsis bundle compliance in our emergency department. This was a before and after study. Historical data on sepsis bundle compliance was obtained from our quality officer. In our institution, the sepsis bundle consists of 1) blood cultures before antibiotics, 2) antibiotics within 1 hr of recognition, 3) serum lactate level at presentation with 3hr repeat if elevated >2, and 4) crystalloid fluid resuscitation of 30cc/kg. Start date was determined by our department’s QI launch; we collected data for 30 consecutive days and compared sepsis bundle compliance rates before and after the intervention. Descriptive statistics were compiled, and the z-test for proportions was used to calculate statistical significance. The intervention was two-fold: 1) a bright yellow card with sepsis criteria listed was posted on all ED workstation computers; and 2) daily email blast for 1 month with “sepsis fun facts.” These email blasts were short pearls that highlighted the importance of recognizing and treating sepsis. The sepsis bundle compliance rates in the month prior to the intervention was 38%. In the month during the targeted intervention, the compliance rate increased to 56%. There was a statistically significant increase in bundle compliance rates during the intervention (P=0.0399). We also administered a survey to the ED attendings and residents following the completion of the study to assess whether they perceived our intervention as helping them increase compliance with ordering the sepsis bundle. The response rate was 94%. To the question “Did you feel the SEPSIS cards placed on the workstations make you more likely to consider sepsis earlier in patients under your care in the emergency department?” 70% answered agree or strongly agree. To the question “Were you more likely to order the SEPSIS bundle after receiving the daily Sepsis “Fun Facts”?” 29% were neutral while 59% answered agree or strongly agree. Finally, to the question “Did you feel the Sepsis Cards and “Fun Facts” help you improve the care of Septic patients in the emergency department?” 76% answered agree or strongly agree. Simple interventions such as sepsis criteria reminders and email blasts highlighting the importance of treating and recognizing sepsis can improve compliance with sepsis bundle ordering within the emergency department. A post-intervention survey suggests that such reminders do influence emergency physicians and increase their awareness of sepsis.