CHI Health Mercy is home to a successful bundle program for sepsis, which can be a very complex condition. Unlike orthopedic or cardiac cases, sepsis symptoms can be masked by other things going on with the patient.
“Sepsis patients present with a wide range of symptoms that may or may not always be picked up in the first couple of hours, which is unlike the other bundles where it’s pretty clear cut who the patient is and exactly what their needs are,” said Denise McNitt, MS, RN, vice president for Patient Care Services at Mercy. “One of the keys to the sepsis bundle program’s success has been the nurse navigators’ ability to collaborate with the physicians to help identify those cases.” McNitt said once those sepsis patients have been identified, the nurse navigators make contact with the patient and follow the patient throughout the hospitalization to assist with the best plan for them after discharge from the hospital.
“The nurse navigator works with physicians and care managers as a second set of eyes for an appropriate plan of care,” McNitt said. “Because some of these patients are very, very sick, they really require quite a bit of coordination. The nurse navigator takes them on from the beginning, follows them while they’re in the hospital and then continues to play a role in the patient’s care for 90 days afterward.”
How sick a sepsis patient is determines whether they will go home, to a skilled care facility or require home care. McNitt said recovery from sepsis can take time as well as require multiple treatment protocols — and requires nurse navigators to maintain close personal contact by phone or visits. Thanks in part to nursing, the sepsis bundle program at Mercy is working.
“Not only did we improve the care of sepsis patients, but we demonstrated cost savings. To me, that’s the key point of these bundles because if we’re not improving the outcomes of patients, we’re not meeting the true objective,” McNitt said.