Pediatrics Resident Yale-New Haven Children's Hospital New Haven, Connecticut, United States
Background: The literature demonstrates that compliance with sepsis bundle (SB) care can reduce the odds of pediatric sepsis mortality by up to 40%. This reduction is attributed to five critical processes in SB: sepsis screening (SS), sepsis huddle (SH), order set utilization, time to the first fluid bolus, and time to the first intravenous antibiotic administration. Although our institution conducts routine SS, a standardized response with a SH to positive screens was not a standard practice in our critical care units [Pediatric Intensive Care Unit (PICU) and the Pediatric Cardiac Intensive Care Unit (PCICU)]. This work is part of a larger quality improvement initiative to improve sepsis care across the hospital. Objective: Our objective was to establish a SH as the standard response to a positive sepsis screen. We aimed to increase the frequency of SH from a baseline of less than one to a target of ten per week in the PICU and PCICU by December 2023. Design/Methods: Using quality improvement strategies we focused on collaborative efforts, process improvements, and staff education. In the fall of 2022, a work group was created, including PICU and PCICU nurses, pediatric residents, pediatric critical care fellows, pharmacists, members of the sepsis steering committee, and informatics resources to focus on SH implementation. SH was defined as a nurse and medical provider meeting at the bedside to evaluate the patient in response to a positive sepsis screen. Beginning in May 2023, the electronic sepsis screen and the navigator were redesigned to encourage SH and improve documentation. Finally, an education campaign was initiated around SH.