TeleICU Impact on Sepsis Outcomes: A Program Evaluation
BACKGROUND: Sepsis is a medical emergency that accounts for one in three hospitalized deaths and costs the United States healthcare system $23.7 billion annually. TeleICU has been recognized as a viable method to support frontline staff with implementing The Surviving Sepsis Campaign’s (SSC) best practice recommendations to improve patient outcomes. THEORETICAL FRAMEWORK: To enhance the current process for sepsis identification and management using the SSC recommendations, a program evaluation of an established teleICU’s impact on sepsis outcomes was conducted using a logic model within the Center for Disease Control and Prevention framework. METHOD: Objective data was collected related to Intensive Care Unit (ICU) sepsis mortality, sepsis related ICU Length of Stay (LOS), sepsis related interhospital transfers, and sepsis bundle compliance. In addition, teleICU nursing staff and nursing staff at two teleICU supported sites (Site 1 and Site 2) were surveyed to analyze the process and workflow of the teleICU program related to sepsis identification and management. RESULTS: After implementation of the teleICU, Site 1 and Site 2 experienced an increase in sepsis bundle compliance (p<.0001). Sepsis related patient outcomes varied between the sites. There was not a difference noted in ICU sepsis mortality (p=.969) or ICU sepsis LOS (p=.489) for Site 1, however there was a decrease in interhospital transfers (p=.023). Conversely, Site 2 experienced a difference in both ICU sepsis mortality (p<.0001) and ICU sepsis LOS (p<.0001), but there was no impact on interhospital transfers (p=.056). Site 1 and Site 2 reported confidence related to the identification and management of sepsis, and both were satisfied with the teleICU’s role in identifying and managing patients with sepsis. Improvement opportunities were noted in the following areas: site feedback related to sepsis outcomes and sepsis bundle compliance; and teleICU process and resources for identifying and managing sepsis. CONCLUSION AND vii IMPLICATIONS: TeleICU is an effective platform for identifying and managing patients with sepsis in the ICU setting. Ongoing staff education, continuous process improvement, and appropriate feedback mechanisms should be in place for optimal patient outcomes and nurse satisfaction.
|Work Title||TeleICU Impact on Sepsis Outcomes: A Program Evaluation|
|License||All rights reserved|
|Deposited||April 27, 2020|
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