Measuring Outcomes and Process Measures
Measuring compliance with each aspect of the resuscitation and management bundles is important. Meeting the specified process measures should impact the patient's outcome and reduce mortality.
Click Diagram A for a visual connection of the process measures to the clinical outcome.
Nursing's Impact
Nursing is in a key position to help prevent and recognize severe sepsis and septic shock. The nurse is to:
• Maintain compliance with hand washing and sterile technique.
• Be alert for severe sepsis and septic shock. Use the screening tool to help identify patients with possible severe sepsis or septic shock.
• Call an RRT and notify the physician if severe sepsis or septic shock is suspected.
• Begin the severe sepsis order set if ordered by the physician. On the general nursing unit that may include obtaining labs, starting the fluid bolus and antibiotic while preparing for transfer to critical care.
Nursing has a huge impact on the outcome of these patients experiencing severe sepsis or septic shock.
• Assure correct fluid bolus (30 ml/kg).
• Document accurate intake and output and communicate if 30ml/kg of IV fluid has been reached.
• Assure antibiotic given ASAP and within the first hour of recognizing severe sepsis/septic shock.
• Facilitate communication of interventions with use of the "Severe Sepsis/Septic Shock Checklist" or similar hand off tool.
• Connect Central line to CVP monitor to ensure adequate fluid resuscitation.
Remember: Delay in recognition or treatment of severe sepsis and septic shock increases the patient's risk of death.
