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. This project brings this innovative education delivery to the bedside.
Problem: A lack of nursing knowledge and confidence of non-intensive care unit (ICU) medical-surgical nurses led to increased ICU transfers and sepsis mortality (outcomes data).
Measurement: The Nurses Sepsis Awareness Questionnaire was administered pre- and post-education via electronic survey. This contained 15 multiple-choice questions to assess knowledge, and five questions using a five-point Likert scale to assess self-perceived confidence. Changes in ICU transfers and sepsis mortality was monitored using run charts.
Analysis: A two-group pre-/post-test design was utilized with a sample of 17 nurses in the non-ICU medical-surgical units. Descriptive statistics were used for demographic data and evaluation of correctly answered knowledge questions. Paired t-tests and Wilcoxon-signed ranks tests were used to analyze outcomes data and knowledge and confidence, respectively.
Implementation: An innovative escape room education was implemented. Obstacles encountered include staffing challenges, competing education and other quality initiatives, and low participation. These were approached and mitigated by providing education at varying times throughout the day. Partnering with nursing professionals to enhance education delivery may reduce ICU transfers and sepsis mortality.
Results/Discussion: A statistically significant improvement in confidence and increased knowledge was demonstrated. Mean ICU transfers decreased pre-/post-interventions on the project units. The PDSA cycle was used to adapt the intervention delivery. Expansion of this project will include a broader sample of nurses. Repeat analysis is warranted to understand retention of knowledge.
