PICOT question

In severe sepsis patients (P), how does an education program for nurses (I) compared to no intervention (C) improve continuation of fluid bolus administration, repeat lactic acid collection and antibiotic administration (O) within 6 months? (T)

PICOT problem

The problem addressed in the PICOT question involves risk reporting on severe sepsis. The needs assessment at Adams Memorial hospital revealed increased concerns for severe sepsis specifically on risk reporting from the emergency department to the medical surgical department. According to Chen et al. (2022), sepsis bundle compliance is critical in the management of severe sepsis as it improves patient outcomes. The needs assessment at Adams Memorial hospital revealed a concern on the sepsis bundle strategy in that continuation of the fluid bolus administration, repeat lactic acid collection, and antibiotic administration is either not properly documented or continuity is not properly maintained.

The clinical issues that may arise from reduced compliance to the sepsis bundle strategy includes increased mortality rate, high rates of readmission and reduced recovery rate for severe sepsis patients. According to Abe et al. (2018), failure to comply with the sepsis bundle or failure to practice proper risk reporting between departments may affect the patient outcomes as well as the quality of health care delivery. The evidence-based solution for severe sepsis management involves sepsis bundle compliance which incorporates the aspect of proper risk reporting between the nursing departments. Therefore, the role of nurses is critical in ensuring that severe sepsis patients receive patent care both within and without the hospital settings through health care agency.

Nursing intervention

The proposed solution for the problem of risk reporting on severe sepsis at Adams Memorial hospital implementing an education program to sensitize the nurses on the importance of adhering to the sepsis bundle. The program will highlight the need for nurses to make use of checklists when risk reporting on sepsis. Additionally, the program will reiterate the need to adhere to the fluid bolus, lactic acid and antibiotic administration in terms of amount given and the frequency of administration (Kempker et al., 2019).

The comparison group will involve the severe sepsis patients before the implementation of the education program on the nurses. It is expected that the patient population will report improved outcomes after the nurses have received training on proper risk reporting and compliance to the sepsis bundle. The expected time frame will be six months which will be sufficient to determine the outcome of the intervention. According to Chabrera et al. (2021), education programs that take at least six months produce satisfactory results for the nursing practice. Therefore, the choice of the six months’ time frame is expected to provide valid and reliable outcome for the severe sepsis patients.

Summary of the clinical problem and patient outcome

The clinical problem which involves risk reporting on severe sepsis by nursing professionals will form the basis of the capstone project. The concerns related to the management of severe sepsis at Adams Memorial hospital revolves around fluid bolus administration, repeat lactic acid collection, antibiotic administration and the use of checklists.

The patient outcome associated with the clinical problem involve proper risk reporting regarding fluid bolus administration, repeat lactic acid collection and antibiotic administration which in turn reduces mortality rate, rehospitalization rates and reduces the length of hospital stay. Therefore, the successful implementation of the education intervention program will positively affect the nursing practice through improved health care service delivery, patient outcomes and health collaboration among the health care professionals (Nunnally & Patel, 2019).


Abe, T., Ogura, H., Shiraishi, A., Kushimoto, S., Saitoh, D., Fujishima, S. & Gando, S. (2018). Characteristics, management, and in-hospital mortality among patients with severe sepsis in intensive care units in Japan: the FORECAST study. Critical Care, 22(1), 1-12. https://doi.org/10.1186/s13054-018-2186-7
Chabrera, C., Dobrowolska, B., Jackson, C., Kane, R., Kasimovskaya, N., Kennedy, S., & Cabrera, E. (2021). Simulation in nursing education programs: findings from an international exploratory study. Clinical Simulation in Nursing, 59, 23-31. https://doi.org/10.1016/j.ecns.2021.05.004
Chen, A. X., Simpson, S. Q., & Pallin, D. J. (2019). Sepsis guidelines. N Engl J Med, 380(14), 1369-1371. https://doi.org/10.1056/nejmclde1815472
Kempker, J. A., Kramer, M. R., Waller, L. A., Wang, H. E., & Martin, G. S. (2019). State-level hospital compliance with and performance in the Centers for Medicaid & Medicare Services’ early management severe sepsis and septic shock bundle. Critical Care, 23(1), 1-4. https://doi.org/10.1186/s13054-019-2382-0
Nunnally, M. E., & Patel, A. (2019). Sepsis-What’s new in 2019? Current Opinion in Anesthesiology, 32(2), 163-168. https://doi.org/10.1097/aco.0000000000000707

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