The Impact of Evidence-Based Sepsis Education on the Recognition of Clinical Deterioration and Reducing Sepsis Mortality Among Inpatient Medical-Surgical Units

Sepsis is one of the leading causes of intensive care unit (ICU) transfers and mortality in the inpatient setting due to delayed recognition and untimely management of sepsis symptoms on non-ICU medical-surgical floors. Educating nurses on units with the highest rates of sepsis mortality and ICU transfers is important to increase confidence and knowledge to promote early recognition of sepsis and implementation of initial management guidelines. There is growing evidence of the effectiveness of escape rooms, however, most studies have been completed with students in academic settings. Additionally, sepsis education is traditionally targeted to the ICU and emergency department (ED) settings, not medical-surgical floors. The purpose of this project was to implement interactive escape room education with evidence-based sepsis content to prepare nurses to identify early warning signs of sepsis and clinical deterioration in medical-surgical patients. A two-group pre-/post-test quality improvement project was conducted with a sample of 17 nurses in the non-ICU medical-surgical units within the medicine service line at the project site. After the interactive escape room educational event, a statistically significant improvement in confidence and increased knowledge was demonstrated. Mean knowledge scores increased from 77.4 (SD=13.7) pre-intervention to 82.4 (SD=14.3) post-intervention. Significant improvements were seen in self-reported knowledge and confidence in identifying sepsis patients (z=2.33, p=.02), knowing how and what to monitor in sepsis patients (z=2.714, p=.007), and knowing initial management of patients with sepsis (z=2.646, p=.008). Mean ICU transfers decreased from 13 (SD=1.0) pre-intervention to 8.67 (SD=3.51) post-intervention indicating the project units performed better than the comparison units. Implementing an innovative escape room education intervention for non-ICU medical-surgical nurses is recommended to improve nurse knowledge and confidence in managing sepsis patients. By increasing nurse knowledge and confidence, earlier recognition of clinical signs of deterioration may assist with reducing ICU transfers related to clinical deterioration due to infections and sepsis.