Answers
NUR 550 Topic 6 DQ1
Identify a quality improvement initiative that relates to improving population health outcomes
for a population with which you are familiar. Have these initiatives been successful? Why or
why not?
Improving the quality of care that is delivered to patients has been a goal for healthcare
systems around the globe for some time now. Each of these organizations strives to do what is
best for all of their patients as in hopes to improve the overall health of populations. One of
the major quality improvement initiates that relates to improving the overall health of
populations is the identification of sepsis upon patient arrival in the emergency department.
Sepsis continues to be a major problem among patients as it is one of the leading causes of
mortality, with more than 700,000 hospitalizations and 200,000 deaths annually (Delawder &
Hulton, 2020). There are various initiatives and tools that exist to aid in the “early
identification and treatment of sepsis, including electronic alert systems, standardized order
sets, nurse-initiated protocols (NIPs) and specially trained teams” (Delawder & Hulton, 2020).
The hospital that I currently work at has program initiatives with the NYS Department of Health
to better identify sepsis and improve patient outcomes. Upon identification of sepsis criteria in
triage, the RN immediately initiates a “code sepsis” and the patient is brought back to the
treatment area with a neon orange code sepsis flow sheet. This is a visual cue to the staff that
the patient meets sepsis criteria and should be seen as soon as possible. Once seen by the RN
and physician, an order set selected and followed in our EHR. This order set includes lab orders
which includes blood cultures, IV fluids based on patient weight, antibiotic administration and
repeat lactate orders all within a 3 hour end goal time. Data collected through the Krasnoff
Quality Management Institute (KQMI, 2019) and Northwell Health’s Emergency Department
shows that this criteria was met 100% of the time when order sets were used. The problems
continue when sepsis is not correctly identified upon arrival, and then patients do not receive
treatment according to these implemented guidelines. Unfortunately, despite available
guidelines, mortality rates for severe sepsis and septic shock are near 50% (Delawder & Hulton,
2020).
References:
Delawder, J. M., & Hulton, L. (2010). An Interdisciplinary Code Sepsis Team to Improve Sepsis-
Bundle Compliance: A Quality Improvement Project. Journal of emergency nursing, 46(1), 91–
98. https://doi.org/10.1016/j.jen.2019.07.001