Implementation of a MEWS‐Sepsis screening tool: Transformational outcomes of a nurse‐led evidence‐based practice project

Roney, Jamie K.; Whitley, Barbara E; Long, JoAnn D.

doi:10.1111/nuf.12408

Cited by 11 publications

(12 citation statements)

References 6 publications

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“…Sepsis protocols. Eight of the selected studies examined the effectiveness of sepsis protocols [24,[36][37][38] and sepsis screening tools [16,[39][40][41] for the early assessment and management of sepsis (Table 7). All of these articles revealed that the implementation of sepsis screening tools or protocols based on the SSC guidelines leads to the early identification and timely management of sepsis, as well as the improvement in nurses' compliance to the SSC guidelines for the detection and management of sepsis.…”

Section: Interventions Directed At Improving Nurses' Sepsis Assessmen...mentioning

confidence: 99%

“…tested to examine their impact on some patient outcomes, and variabilities were identified. For example, the use of the Modified Early Warning Score (MEW-S) tool revealed no significant improvement in patient mortality rate [41]. In contrast, mortality rates were decreased by using the Nurse Driven Sepsis Protocol (NDS) [40], Quality Improvement (QI) initiative [38], and a computerized protocol [37].…”

Section: Plos Onementioning

confidence: 99%

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Sepsis assessment and management in critically Ill adults: A systematic review

2022

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Background Early assessment and management of patients with sepsis can significantly reduce its high mortality rates and improve patient outcomes and quality of life. Objectives The purposes of this review are to: (1) explore nurses’ knowledge, attitude, practice, and perceived barriers and facilitators related to early recognition and management of sepsis, (2) explore different interventions directed at nurses to improve sepsis management. Methods A systematic review method according to the PRISMA guidelines was used. An electronic search was conducted in March 2021 on several databases using combinations of keywords. Two researchers independently selected and screened the articles according to the eligibility criteria. Results Nurses reported an adequate of knowledge in certain areas of sepsis assessment and management in critically ill adult patients. Also, nurses’ attitudes toward sepsis assessment and management were positive in general, but they reported some misconceptions regarding antibiotic use for patients with sepsis, and that sepsis was inevitable for critically ill adult patients. Furthermore, nurses reported they either were not well-prepared or confident enough to effectively recognize and promptly manage sepsis. Also, there are different kinds of nurses’ perceived barriers and facilitators related to sepsis assessment and management: nurse, patient, physician, and system-related. There are different interventions directed at nurses to help in improving nurses’ knowledge, attitudes, and practice of sepsis assessment and management. These interventions include education sessions, simulation, decision support or screening tools for sepsis, and evidence-based treatment protocols/guidelines. Discussion Our findings could help hospital managers in developing continuous education and staff development training programs on assessing and managing sepsis in critical care patients. Conclusion Nurses have poor to good knowledge, practices, and attitudes toward sepsis as well as report many barriers related to sepsis management in adult critically ill patients. Despite all education interventions, no study has collectively targeted critical care nurses’ knowledge, attitudes, and practice of sepsis management.

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Section: Interventions Directed At Improving Nurses' Sepsis Assessmen...mentioning

confidence: 99%

Section: Plos Onementioning

confidence: 99%

Sepsis assessment and management in critically Ill adults: A systematic review

2022

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“…In this sense, the nursing team has a fundamental role, as patient monitoring is predominantly performed by these professionals. Nurses remain at the bedside for much longer and often recognise the patient with sepsis early, facilitating the beginning of treatment and favouring a positive outcome (Rhodes et al, 2017; Roney et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

“…Nurses remain at the bedside for much longer and often recognise the patient with sepsis early, facilitating the beginning of treatment and favouring a positive outcome (Rhodes et al, 2017;Roney et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Septic shock: Clinical indicators and implications to critical patient care

Pinto

Azzolin

Lucena

et al. 2021

Journal of Clinical Nursing

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Aims and Objective To identify clinical indicators of septic shock in critical care patients. Background The identification of clinical indicators of septic shock is relevant to avoid clinical deterioration of patients with sepsis. However, the recognition of these factors, especially by the nursing team, is still deficient and reinforces the need for studies that investigate the subject in different realities such as that of Brazil. Design The study had a cross‐sectional design based on STROBE guidelines (see Appendix S1). Methods A sample of 392 patients with sepsis or septic shock was admitted to the Intensive Care Unit of a Brazilian university hospital. Data were collected from medical records of the Intrahospital Sepsis Combat Program referring to patients admitted between January 2018–January 2019. Sociodemographic and clinical data were collected, as well as information on the time from diagnosis of sepsis or septic shock to initiation of antibiotic therapy, length of stay, and discharge or death outcomes. Data were statically analysed. Results Out of the total sample, 190 (49%) patients were admitted with septic shock. Clinical indicators of septic shock were hypotension, mechanical ventilation, lactate levels between 2.0–3.9 or >4, hypothermia <36°C, radiotherapy‐associated chemotherapy, Sequential Organ Failure Assessment score >3 and admittance through the emergency unit. Among patients with septic shock, 85 (44.7%) were discharged and 105 (55.2%) died in the intensive care unit. Conclusions Patients with septic shock presented hyperlactataemia and greater organic dysfunction as clinical indicators when compared to patients with sepsis. Mechanical ventilation, chemotherapy and radiotherapy increased the risk of developing septic shock. Relevance to clinical practice Our results can support the nursing team by providing the main clinical indicators of septic shock and contributing to the interprofessional team in the prevention of septic shock.

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“…Research supports the integration of EBP to enhance quality of health care, improve health outcomes, reduce variations in care and decrease costs (Melnyk et al, 2012;Pravikoff et al, 2005;Spies et al, 2018). The integration of evidence-based interventions in nursing care can greatly improve patient outcomes such as decreasing hospital-acquired pressure ulcers and reduction of sepsis-related clinical concerns (Barakat-Johnson et al, 2020;Jacobs, 2020;Roney et al, 2020). Students need to see the incorporation of EBP as a way to address any decision in patient care rather than something extra to do.…”

Section: Introductionmentioning

confidence: 99%

Academic‐clinical nursing partnership use an evidence‐based practice model

Bowles

Buck

Brinkman

et al. 2021

Journal of Clinical Nursing

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Aims and objectives: The purpose of this study was to compare the experience of a new clinical model with traditional clinical teaching and examine the effects of evidence-based practice strategies among staff and student nurses. Background: This provides an innovative approach to nursing student clinical learning that emphasised the academic-clinical partnership with the use of a new model called the Evidence-based Clinical Academic Partnership (ECAP) model. The model incorporates three main components (a) unit transformation into an innovative hybrid version of a dedicated education unit (hDEU); (b) Evidence-in-Action (EIA) rounding; and (c) the cognitive apprenticeship theoretical framework.Design: This pilot study used a mixed-method, quasi-experimental design. Methods:The quantitative portion included a pre-test, post-test non-randomised quasi-experimental design using self-reported survey data. The qualitative methodology used was a hermeneutic phenomenological approach to data interpretation of three focus groups with staff nurses and unit leaders. SQUIRE 2.0 guidelines were followed (Ogrinc et al., 2016). Conclusions:The themes that emerged emphasised relationships and the partnership with this innovative approach to clinical teaching. The staff nurses emphasised the need for a collaborative approach and having the presence of the academic faculty member as a way to support the teaching and learning aspects with students. Relevance to clinical practice:This study did provide significant contributions to the development of an innovative clinical model and highlighted the importance of the academic-clinical partnership with the education of undergraduate nursing students.The study results provided insight to the ways the hDEU framework may be strengthened, such as increased communication and partnership in the implementation of the ECAP model. Implementing curricular change to include innovative clinical models within a nursing programme is vital in this time of healthcare transformation.

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Implementation of a MEWS‐Sepsis screening tool: Transformational outcomes of a nurse‐led evidence‐based practice project

Cited by 11 publications

References 6 publications

Sepsis assessment and management in critically Ill adults: A systematic review

Sepsis assessment and management in critically Ill adults: A systematic review

Septic shock: Clinical indicators and implications to critical patient care

Academic‐clinical nursing partnership use an evidence‐based practice model

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