Pioneers Memorial Healthcare District continues to seek improvement in all areas of healthcare. Each year we target several specific areas and provide a focused analysis of the steps needed to improve patient outcomes. One of the areas targeted has been the treatment of sepsis.
Sepsis is the body’s system-wide response to infection. The signs and symptoms of sepsis include fever, chills, reduced mental alertness, nausea and vomiting, diarrhea, increased heart rate in excess of 90 beats per minute in an adult, high or low white blood cell count ( part of the immune system that helps fight infection), low blood pressure, and altered kidney or liver function. Sepsis can progress to septic shock, where the systems of the body begin to shut down and the blood pressure drops dangerously low. The death rate from septic shock can be as high as 40 percent.
Sepsis is on the rise due to the increasing number of elderly or debilitated patients; patients with underlying diseases such as cancer that require intensive treatment; the widespread use of antibiotics, which encourages the growth of drug-resistant micro-organisms; and technological advances in treatment that require invasive procedures.
In the United States, it is estimated that there are approximately 750,000 new sepsis cases each year, with at least 210,000 deaths.
In November 2009, the ER and ICU team at Pioneers Memorial Hospital undertook the challenge of decreasing by 25 percent the death rate from sepsis (a goal set by the Surviving Sepsis Campaign) and shortening the time spent in the hospital for patients with sepsis by two days. Using evidence-based-practice protocols recommended by the Surviving Sepsis Campaign, and through extensive staff training and the purchase of special monitoring equipment, the team was able to exceed these goals.
By the first of the year 2011, the mortality (death) rate for severe sepsis and septic shock, combined (the two most severe forms of sepsis), dropped by 37 percent, and the time spent in the hospital for these most severe forms of sepsis, combined, dropped by more than three days.
These significant accomplishments were a direct result of the team effort led by Michael Krutzik, MD, FCCP; Eva La Pena, RN, CEN Nurse Educator; and Robyn Atadero, RN BSN, Critical Care Nursing Director.