Implementation of an Evidence-Based, Nurse-Driven Sepsis Protocol to Reduce Acute Care Transfer Readmissions in the Inpatient Rehabilitation Facility Setting

Abstract

Purpose 

The aim of this study was to determine if implementing an evidence-based, nurse-driven sepsis protocol would reduce acute care transfer (ACT) readmissions from an inpatient rehabilitation facility compared to nonprotocolized or usual standard of care for adult sepsis patients undergoing physical rehabilitation.

Design 

This study used a preintervention and postintervention model for quality improvement, which involved comparing the nonprotocolized care of adult sepsis patients in the inpatient rehabilitation population to the application of an evidence-based, nurse-driven sepsis protocol to determine its effect on reducing ACT readmissions.

Methods 

Patients who screened positive for suspected sepsis and received protocolized interventions were analyzed to determine the occurrence of ACT readmission. Compliance with protocol elements was also evaluated.

Findings 

The sepsis-related ACT readmission rate decreased from 36.28% to 25% in 8 weeks, and compliance with protocolized sepsis interventions increased.

Conclusions 

Nurse-driven, protocolized assessment and treatment can improve the management and care of sepsis patients undergoing physical rehabilitation and can reduce ACT readmissions.

Clinical Relevance 

This review provides rehabilitation nurses an evidence-based, nurse-driven approach to the clinical management of sepsis patients in the inpatient rehabilitation setting and discusses how this approach can reduce ACT readmissions and improve clinical outcomes.