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Nursing Clinical Information System (NCIS)
A Nursing Clinical Information System (NCIS) is a specialized type of healthcare information system tailored to meet the unique needs of nursing practice. It incorporates the principles of nursing informatics to streamline information management and improve the quality of care delivery.
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Nursing management of pneumonia involves promoting airway patency, facilitating rest and conserving energy, encouraging fluid intake, maintaining nutrition, and educating patients.
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The condition of being free from disease-causing living pathogens is asepsis. Aseptic techniques include a set of standard practices to achieve asepsis. An example is the regular environmental cleaning of all parts of the healthcare facility and hand hygiene at home before preparing or eating food. Medical and surgical asepsis in healthcare practice protects patients from harmful pathogens, minimizes the risk of contamination of susceptible sites, and reduces the risk of infection transmission.
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ED Nurse-Led Code Sepsis to Reduce Time to Antibiotics.

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A nurse-led sepsis team in the Emergency Department (ED) significantly reduced door-to-antibiotic times and patient mortality. This initiative improved sepsis recognition and treatment, leading to better patient outcomes and surpassing hospital benchmarks.

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Area of Science:

  • Emergency Medicine
  • Infectious Disease
  • Nursing Leadership

Background:

  • Delays in sepsis recognition and antibiotic administration increase patient morbidity and mortality.
  • Previous sepsis outcomes at a community hospital necessitated a quality improvement initiative.

Purpose of the Study:

  • To establish an Emergency Department (ED) Code Sepsis Nurse-led team.
  • To decrease the time to antibiotic administration and reduce mortality in sepsis patients.

Main Methods:

  • Implemented a dedicated Sepsis Nursing Team with specialized training.
  • Developed and utilized an electronic ED-sepsis screening tool.
  • Established a "Code Sepsis" activation process triggering a multidisciplinary response and standing orders for diagnostics and treatment.
  • Conducted monthly Sepsis Task Force meetings led by a Registered Nurse (RN) Captain to foster engagement.

Main Results:

  • Reduced door-to-antibiotic time from 196.7 minutes in Q1 to 144.7 minutes in Q4 of Fiscal Year 2021.
  • Decreased patient mortality below the health system average (10.4% vs. 13.5%).
  • Achieved a readmission rate of 0.5%, surpassing the benchmark of <1.0.

Conclusions:

  • An RN-led, interprofessional sepsis response model improved sepsis recognition and treatment.
  • Enhanced staff and physician engagement contributed to better patient mortality and hospital reporting outcomes.
  • The sepsis response process was successfully adopted with minimal challenges.