Filtering by
- All Subjects: Screening
- Creators: Nunez, Diane
Background: Sepsis remains a significant healthcare problem associated with high treatment costs and high mortality rates. Older adults are at an increased risk for developing sepsis, especially when age is combined with any type of compromising factor, such as chronic illness, recent hospitalizations, wounds, or invasive devices. Current evidence demonstrates that sepsis screening is effective for early identification of sepsis. Early identification of sepsis improves time to treatment initiation, which improves outcomes.
Methods: An evidence-based, provider approved clinical guideline was developed for a post-acute care facility after an extensive review of the literature. Upon implementation, brief educational sessions were provided to direct patient care staff. Participants completed pre- and post-tests as well as a demographic survey. A satisfaction survey was administered 30 days post intervention. A paired samples t-test was used to analyze the difference in test scores. Pearson's correlation was used to analyze the relationship between staff comfort levels and the clinical guideline.
Results: The samples included 25 participants in the educational intervention and 18 in the satisfaction survey. There was a significant difference in the scores between pre-test (M = 72.3, SD = 12.43) and post-test scores (M = 86.6, SD = 10.2); t(24) = -5.578, p < 0.001. There was a significant correlation between staff who felt comfortable in identifying sepsis with ease of screening (r = .831, p < .01) and high comfort levels with the policy (r = .889, p < .01).
Conclusion: Utilizing a clinical guideline, coupled with education, improves staff knowledge and comfort identifying sepsis in the post-acute care setting, which may improve early recognition and treatment initiation. This outcome is clinically significant as patients in this setting represent a vulnerable population.
Purpose: This project sought to evaluate the gap that exists between best practice and current practice, for sepsis identification and EGDT implementation.
Methods: The project was completed over a four-month period with prior Institutional Review Board (IRB) approval and consisted of evaluation of sepsis knowledge and barriers to EGDT. Questionnaires included demographics, sepsis knowledge, barriers to EGDT and AHRQ quality indicators toolkit.
Results: Sample (N=16) included registered nurses (RN) and healthcare providers. Descriptive statistics were utilized for evaluation of questionnaires. Results indicate staff have sound understanding of signs and symptoms of sepsis, however application through case studies demonstrated lower performance. Overall system barriers were minimal, with greatest barriers in central line monitoring and staff shortages. High level unit teamwork exists within the ED, however collaboration is lacking between ED staff and upper management. Results demonstrate moderate disengagement between upper management and staff leading to miscommunication. Recommendations included increased, consistent sepsis education, utilization of Institution for Healthcare Improvement (IHI) triple aim framework for evaluating systems, implementing a closed loop approach to communication, and having a staff champion for sepsis be included in meetings with upper management.
Purpose: Implementation of a postpartum depression (PPD) screening while using evidence-based interventions to improve depressive symptoms, enhance breastfeeding (BF) self-efficacy, and strengthen the mother-infant dyad (MID).
Background and Significance: PPD is highly prevalent among women living in the United States and threatens the physical and psychological health of MIDs. Many of these women go undiagnosed and without treatment, further worsening symptoms and outcomes. This has inspired world healthcare leaders and organizations to address maternal mental health among postpartum women.
Methods: A 12-week evidenced-based project consisted of two-sets of participants including mothers and staff. A comprehensive maternal support program guided by an informational pamphlet (IP) and implementation of PPD screening using the Edinburgh Postnatal Depression Scale served as the two-part intervention for this project. Goals were to decrease PPD, enhance BF satisfaction, and strengthen the MID. Comprehensive maternal support encompasses interventions proven to meet the project goals and includes tailored BF education and care to maternal needs, social support by peer/family involvement, skin-to-skin contact during BF, emotion-regulation strategies, and availability of community resources.
Outcomes: The BSES-SF scores did result in statistical significance based on an alpha value of 0.10, t(3) = -2.98, p = .059, proving a positive effect was seen in breastfeeding self-efficacy post intervention. The results did not show statistical significance (t(3) = 0.60, p = .591) in regard to pre and post-depression scores. However, the mean pre-score (M =3.50, SD 3.11) did decrease post-intervention (M =2.75, SD 1.26) and exemplifies clinical significance.
Conclusion: The outcomes of this Quality-Improvement project showed improved scores for depression and BF self-efficacy post-intervention. This demonstrates the value in screening for PPD using a validated screening tool and instituting comprehensive maternal support guided by evidence-based practice in a community setting.
Background and Significance: Evidence shows primary care providers (PCPs) are not adhering to the GOLD Guidelines for COPD screening.
Methods: Guideline education with pre/post-intervention survey and percent of eligible participants screened.
Results: Pre-intervention surveys (n=10) and post-intervention surveys (n=8) completed. Significant increase in knowledge regarding the CAT score (M score = 11.50, U = 24.000, p<.05). Part 2) 24% (n=6) of participants were screened with the CAT questionnaire.
Conclusions: PCPs are aware of the GOLD Guidelines, but do not always adhere to its recommendations. Future research should concentrate on effective ways to implement the GOLD Guidelines screening recommendations in primary care clinics.