Presentation on theme: "SEPSIS Team Striving for Excellence. Columbus, GA 376 Bed facility Religious affiliated Community owned www.wecareforlife.com www.wecareforlife.com."— Presentation transcript:
Columbus, GA 376 Bed facility Religious affiliated Community owned www.wecareforlife.com www.wecareforlife.com St. Francis Hospital
Identify signs and symptoms of Sepsis. Identify strategies to improve care for Sepsis Patients Objectives
SIRS (Systemic Inflammatory Response Syndrome) – A clinical response to a nonspecific insult of either infectious or noninfectious origin. Emedicine.medscape.com Sepsis – SIRS in the presence of infection (Lilly) – Process of malignant intravascular inflammation. Exaggerated response of the immune system, exhibited by widespread inflammation – Causes endothelial damage; can progress to multiple organ system dysfunction UpToDate SIRS & Sepsis
Sepsis strikes 1,000,000 people each year in U.S. 28-50% of these people die (~200,000) Far more than the number of U.S. deaths from prostate cancer, breast cancer and AIDS combined ~1400 deaths per day in the world Surviving Sepsis Campaign Statistics
Failure of Immune Cascade (widespread inflammation) Clotting Cascade: Abnormal Coagulation Hypoxia (lack of O2) Hypoperfusion (decreased blood flow to organs) Endothelial Damage (vascular damage/collapse— shock) Lactate buildup Sepsis: What goes wrong?
Temperature: > 100.4°F or < 96.8°F Heart Rate > 90 Resp. Rate > 20 (or PaCO2 <32) WBC > or = 12,000 or < 4000 (Bandemia: > or = 10% Bands) (Bands: Immature Neutrophils) SIRS Criteria
Procalcitonin (PCT) CRP Interleukin-6 (IL-6) Lactate There are no true biomarkers for sepsis. Some research suggests PCT has > sensitivity/specificity. Otterman, M (Medscape) 2013 Bio-Markers for Sepsis??
Mild Lactate < 2mMol/L Moderate Lactate > 2mMol/L or organ dysfunction Severe Lactate >4mMol/L Admit to Critical Care Unit Mild, Moderate, Severe Sepsis
Sepsis Team Progression 2009 Expectations set to reduce Sepsis mortality (higher than expected) 2010 Combined Pneumonia & Sepsis teams 2011 set as Organizational strategic goal to reduce Sepsis mortality rate Sepsis Team formed 2012 Identified Opportunities for early goal directed care education 2013 Prioritized utilization of Sepsis orders 2014 Implemented Antibiotic Stewardship (72 hour reviews)
Slide 1 Our Team Mission Provide Best Care High quality Disease focused Evidence-based Partnership Patients/Families Community Physicians Improve Sepsis Outcomes Decrease LOS Decrease Mortality
Team Leader (Physician: Dr. Kevin King) Admin Rep (VP Patient Care) Physician Consultants (5 Physicians) Multidisciplinary Team Quality/Core Measure Reps Nursing Leadership/Education Case Management Pharmacy/Respiratory/Laboratory Clinical Applications/IT Our Team
The clock is ticking… Sepsis Mortality increases by 7% every hour if not treated appropriately Proper Antibiotic selection is crucial
Sepsis Risk Assessment Tool Paper form: Done on all direct admissions Electronic Sepsis Screening (ED) Lactate Point of Care Testing Now in our ED Sepsis Dashboard Ongoing data collection In use since 2011 The War Continues
Are You Smarter than a Fifth Grader…about Sepsis??
Stop Sepsis! Advice from a 5 th Grader Advice from a 5 th Grader: Wash Hands Get Flu Shots Cover your Mouth Get Healthy