Orange Park Out-of-Hospital Quality Improvement Study for Improving CMS Sepsis Core Measures

Orange Park Out-of-Hospital Quality Improvement Study for Improving CMS Sepsis Core Measures

The goal of this quality improvement study is to measure the impact of incorporation of a manual rapid fluid infuser (RFI) for intravenous crystalloid infusion in patients with suspected sepsis in the prehospital interval.

The main question[s] it aims to answer are:

• Does the intervention affect the timeliness of fluid administration?
• Does the intervention affect CMS sepsis bundle care measure compliance?
• Does the intervention affect processes and outcomes of care?
• Are there any adverse effects?

Researchers will compare this intervention to use of more conventional gravity or pressure-infusion bag crystalloid infusion.

Inclusion Criteria:

Patients meeting sepsis alert criteria who were transported to the study hospital's emergency department by one of the four rescue units involved in the study. Sepsis alert defined as patient has suspected infection and two or more of the following: (a) temperature > 38° C (100.4° F) or < 36° C (96.8° F), (b) respiratory rate > 20 breaths / minute or end-tidal carbon dioxide (ETCO2) ≤ 25 mmHg, or (c) heart rate > 90 beats / minute

Exclusion Criteria:

• prehospital trauma
• prehospital cardiac arrest prior to signaling sepsis alert
• interfacility transfer
• emergency transport from medical facility (e.g., medical office or clinic)
• intervention by medical practitioner before emergency medical services arrival
• do not resuscitate order in place