Abstract
Background: Pediatric sepsis has a mortality rate of 10.6% which means approximately 7,950 children die annually (Scott et al., 2017; Balamuth et al., 2015;Paul, Neuman, Monuteaux, & Melendez, 2012). Studies indicate that the best defenses in sepsis is early recognition and immediate interventions; however, the pediatric population is often underrecognized. Recently pediatric specific guidelines were developed by accrediting organizations but have low compliance rates.|Objective: To increase compliance a quality improvement project was developed to reduce the time from arrival in the emergency department to the initiation of a standardized protocol.|Methods: The John Hopkins Nursing Evidence-Based Practice Model (JHNEBP) provided an open framework with unified components that allowed internal and external factors to influence practice, education, and research during the quality improvement process. A Plan-Do-Study-Act (PDSA) methodology design was the chosen model for improvement. The process educated nurses and providers on the current best practice standards, the difference in the pathophysiology of pediatric sepsis, and the new pediatric sepsis bundle being implemented. The pediatric sepsis bundle included a pediatric sepsis screening tool, a best practice advisory alert, and a pediatric sepsis order set which were implemented into the electronic charting system, EPIC. Outcomes indicators measured the adherence to the pediatric sepsis bundle. Outcome variables were time to recognition of sepsis, time to vascular access, time to fluid bolus, and time to appropriate antibiotics. Data was collected using prospective and retrospective chart reviews.|Keywords: Pediatric, early recognition, sepsis, emergency department, guidelines, pediatric sepsis